Individual
MRS. DARLA K. TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHA
Contact information
Practice address
202 N BLINE BLVD, ROBINSON, IL 62454-1264
(618) 544-8798
Mailing address
7712 E WESTLAKE DR, ROBINSON, IL 62454-4879
(618) 544-9273
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
041-194691
IL
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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