Individual
MEGHAN TRACEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1405 CLIFTON RD NE, ATLANTA, GA 30322-2959
(404) 785-0369
Mailing address
1001 JOHNSON FY RD NE APT 36, ATLANTA, GA 30342-1605
(404) 785-0369
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
280040
MA
363L00000X
Nurse Practitioner
Primary
RN218122
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0718386
—
MA
Enumeration date
09/17/2008
Last updated
03/18/2022
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