Individual
TRACY EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 CLIFTON RD NE, ATLANTA, GA 30322-4200
(404) 727-1915
Mailing address
2543 STARFIRE LN, LOGANVILLE, GA 30052-8660
(404) 727-1915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN059166
GA
Other
Enumeration date
05/22/2015
Last updated
05/22/2015
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