Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN9258136 | FL |
N | 363LA2200X | Nurse Practitioner - Adult Health | APRN9258136 | FL |
NPI | 1023428182 |
---|---|
Provider Name | Ms. Tracy L Czop |
First Address | Temple Terrace, FL 33637-0926 |
Second Address | Temple Terrace, FL 33637-0926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 10/10/2019 |