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Individual

MS. DEBBIE CLARK TRACY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP, CNS

Contact information

Practice address
210 W SAN BERNARDINO RD, COVINA, CA 91723-1515
(626) 938-7586
Mailing address
210 W SAN BERNARDINO RD, COVINA, CA 91723-1515
(626) 938-7586

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17135
CA
364SA2100X
Acute Care Clinical Nurse Specialist
2077
CA

Other

Enumeration date
07/16/2008
Last updated
07/16/2008
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