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Individual

MS. TRACEY LYNN SCISSUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
424 DECATUR ST SE, ATLANTA, GA 30312-1848
(404) 880-3567
Mailing address
PO BOX 72756, MARIETTA, GA 30007-2756
(770) 861-6577

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN158406
GA

Other

Enumeration date
04/04/2008
Last updated
04/04/2008
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