Individual
TRACEY WILSON
Active
Individual
TRACEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RCFE
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
6029334740
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6029334740
RCFE ADMINISTRATOR CERTIFICATION
CA
Enumeration date
11/02/2017
Last updated
11/02/2017
Update your record
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