| Doctor Name: | MS. TRACEY LYNN NOVAK |
| NPI Number: | 1740305978 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | RN9216202 |
| Business Practice Address: | 12889 Us Highway 98 W Ste 107 B Miramar Beach, FL - 325503243 |
| Business Phone Number: | 8508371271 |
| Business Fax Number: | 8504602279 |
| Mailing Address: | 12889 Us Highway 98 W, Ste 107 B MIRAMAR BEACH |
| State: | FL |
| Postal Code: | 325503243 |
| Phone Number: | 8508371271 |
| Fax Number: | 8504602279 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 10/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | RN9216202 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |