| Doctor Name: | TRACI LYNN BOOTH |
| NPI Number: | 1427323641 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 47228 |
| Business Practice Address: | 184 E 2nd Ave Ste 1 Williamson, WV - 256613602 |
| Business Phone Number: | 3042352930 |
| Business Fax Number: | 3042352933 |
| Mailing Address: | 184 E 2nd Ave Ste 1, WILLIAMSON |
| State: | WV |
| Postal Code: | 256613602 |
| Phone Number: | 3042352930 |
| Fax Number: | 3042352933 |
| NPI Enumeration Date: | 03/21/2012 |
| NPI Last Update Date: | 05/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 47228 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |