Tracie Ledora Mitchem-green F.N.P

NPI 1942321575 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1942321575
Gender Female
Enumeration Date 04/02/2007
Last Updated 05/21/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
295 NW COMMONS LOOP # 115-105
LAKE CITY FL, 32055-7721, US
Phone (803) 381-7690
Fax
Business Location
295 NW COMMONS LOOP # 115-105
LAKE CITY FL, 32055-7721, US
Phone (803) 381-7690
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Florida
License Number 9304575
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According to our database, Tracie Ledora Mitchem-green F.N.P NPI is 1942321575, taxonomy code is 363LF0000X and license number is 9304575, license state is located at Florida. Tracie Ledora Mitchem-green F.N.P physically located at 295 Nw Commons Loop # 115-105, Lake City FL, 32055-7721. NPI Number Tracie Ledora Mitchem-green F.N.P has the Individual type.

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1942321575 NPI number is provided on an as is basis without warranty of any kind. 1942321575 is maintained by the National Plan & Provider Enumeration System. The contents of Tracie Ledora Mitchem-green F.N.P are for informational purposes only.