Individual
JACQUELINE TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
861198
KS
Other
Enumeration date
12/27/2016
Last updated
12/27/2016
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