Individual
TRACY T ALJABI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
648 CRESTWOOD DR., COVINGTON, LA 70433
(504) 228-0372
Mailing address
13 SHADOWWOOD DR, CARRIERE, MS 39426-8176
(504) 228-0372
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
211863
LA
363LF0000X
Family Nurse Practitioner
211863
LA
363LF0000X
Family Nurse Practitioner
Primary
903794
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056763
STATE NARCOTICS LICENSE
LA
01
—
211863
STATE LICENSE
LA
Enumeration date
01/23/2020
Last updated
03/07/2023
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