Individual
TRACEY ANNE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
23D MEDICAL GROUP 3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-1459
Mailing address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-1459
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
447542
NY
363LW0102X
Women's Health Nurse Practitioner
Primary
421094
NY
Other
Enumeration date
03/26/2012
Last updated
05/01/2018
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