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Individual

TRACY PUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
23842 W CHIPMAN RD, BUCKEYE, AZ 85326-7340
(661) 349-5126
Mailing address
23842 W CHIPMAN RD, BUCKEYE, AZ 85326-7340

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
270949
AZ

Other

Enumeration date
04/03/2023
Last updated
04/03/2023
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