Individual
TRACEY A YEBOAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024179040
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F02201132
—
VA
Enumeration date
02/27/2020
Last updated
03/27/2020
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