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Individual

TRACY L HOULE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
204 KEEGAN RD, PLYMOUTH, CT 06782-2608
(860) 340-8280
(860) 283-9851
Mailing address
12 ROLLING RIDGE CT, PROSPECT, CT 06712-1737
(203) 758-0836
(203) 758-0836

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2671
CT
364SM0705X
Medical-Surgical Clinical Nurse Specialist
002671
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004247963
CT
Enumeration date
05/13/2006
Last updated
02/02/2012
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