Individual
MRS. TRACESHA ANN BRUMMITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1787 BROAD ST, LUMPKIN, GA 31815-3045
(229) 838-4900
Mailing address
5232 KINGSBERRY ST, COLUMBUS, GA 31907-4233
(706) 563-3194
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN170053
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN170053
GA
Other
Enumeration date
06/17/2016
Last updated
02/22/2018
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