Doctor Name: | TRACY L HILDEBRAN |
NPI Number: | 1023094661 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.N.P. |
License Number: | NC900391 |
Business Practice Address: | 611 Mocksville Ave Salisbury, NC - 281442705 |
Business Phone Number: | 7046337220 |
Business Fax Number: | 7042162232 |
Mailing Address: | 611 Mocksville Ave, SALISBURY |
State: | NC |
Postal Code: | 281442705 |
Phone Number: | 7046337220 |
Fax Number: | 7042162232 |
NPI Enumeration Date: | 12/15/2005 |
NPI Last Update Date: | 01/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | NC900391 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |