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General NPI Number Information
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NPI Number | 1528521713
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Entity Type | Individual
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Provider Name | TRACY SUTTON APRN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2019
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 4320 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3512
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Country | US
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Telephone | 954-276-8367
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Fax | 954-893-6333
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Provider Business Mailing Address
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Address Line | 5223 SW 91ST TER
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City | COOPER CITY
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State | FL
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Zip | 33328-5024
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Country | US
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Telephone | 954-252-1453
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9242659
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License Number State | FL
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