Individual
MRS. TRACIE L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
601 JOHN ST, STE 100, KALAMAZOO, MI 49007-5341
(269) 373-1222
(269) 373-6270
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 373-1222
(269) 373-6270
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4707176515
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003822412
BCBSM - BRONSON
MI
05
—
1912928698
—
MI
Enumeration date
07/21/2006
Last updated
11/27/2023
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