Individual
TRACEY SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6349 U.S. HIGHWAY 550, CUBA, NM 87013
(575) 289-3291
Mailing address
6351 HWY 550, APT B, CUBA, NM 87013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53377
NM
363LF0000X
Family Nurse Practitioner
APN0000022126
TN
Other
Enumeration date
08/07/2017
Last updated
08/17/2018
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