Individual
TRACY SLADE TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
36605 OUTBACK RD, DENHAM SPRINGS, LA 70706-8545
(225) 667-3135
Mailing address
36605 OUTBACK RD, DENHAM SPRINGS, LA 70706-8545
(225) 667-3135
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
990505
LA
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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