Individual
TRACEY RENEE' TENNESSEE
Active
Individual
TRACEY RENEE' TENNESSEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
641983-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
641983
NY
Other
Enumeration date
06/21/2011
Last updated
08/25/2025
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