Individual
TRACEY GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 HALEY BARBOUR PARKWAY, YAZOO, MS 39204
(601) 260-6330
Mailing address
2125 SCANLON DRIVE, JACKSON, MS 39204
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901381
MS
Other
Enumeration date
02/14/2017
Last updated
01/11/2019
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