Individual
TRACI EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4540 W RAILROAD ST, GULFPORT, MS 39501-2480
(228) 867-6062
(228) 867-2598
Mailing address
PO BOX 1810, GULFPORT, MS 39502-1810
(228) 867-6062
(228) 867-2598
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R877630
MS
Other
Enumeration date
02/27/2012
Last updated
12/17/2024
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