Individual
MRS. TRACY ANN FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 DUTCH FORK RD, IRMO, SC 29063-8822
(803) 743-6533
Mailing address
1020 DUTCH FORK RD, IRMO, SC 29063-8822
(803) 743-6533
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
108485
SC
163WS0200X
School Registered Nurse
Primary
RN 108485
SC
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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