Individual
MS. TRACY LEE NIXON-EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., OTR/L
Contact information
Practice address
344 LAKE RD, HERTFORD, NC 27944-8775
(252) 334-9800
(252) 334-9919
Mailing address
344 LAKE RD, HERTFORD, NC 27944-8775
(252) 334-9800
(252) 334-9919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5976
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14230
BCBS
NC
05
—
7301921
—
NC
Enumeration date
07/17/2006
Last updated
02/28/2013
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