Individual
MRS. TRACI LYNN CHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, NNP-BC
Contact information
Practice address
5201 HARRY HINES BLVD, NEONATAL ICU, DALLAS, TX 75235-7708
(214) 590-8487
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
136981
OK
363LN0000X
Neonatal Nurse Practitioner
Primary
601936
TX
Other
Enumeration date
01/08/2008
Last updated
08/19/2020
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