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Individual

TRACI LAVERN MAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, DHS

Contact information

Practice address
871 PACER CT, CORYDON, IN 47112
(812) 738-0317
Mailing address
871 PACER CT, CORYDON, IN 47112
(812) 738-0317

Taxonomy

Speciality
Code
Description
License number
State
364SL0600X
Long-Term Care Clinical Nurse Specialist
Primary
28256382A
IN

Other

Enumeration date
07/12/2021
Last updated
07/12/2021
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