Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2007-00588 | NC |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | TRN9084 | FL |
NPI | 1023104981 |
---|---|
Provider Name | Tracie Christine Farmer |
First Address | Winston Salem, NC 27103-5616 |
Second Address | Winston Salem, NC 27103-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
507624 | (02) | FL |
5907257 | (05) | NC |