Individual
MICAELA M TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Mailing address
326 E JEFFERSON AVE, SAINT LOUIS, MO 63122-4541
(217) 653-7242
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95209963
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
95032714
CA
Other
Enumeration date
09/01/2020
Last updated
02/25/2025
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