Individual provider · Type 1 NPI
Tracey Dianne Ecklund
Student in an Organized Health Care Education/Training Program · Canyon, TX
NPI number
1811400666
Active
Practice location
2620 Russel Long Blvd
Canyon, TX 79016-0001
Mailing address
12655 Raymond Rd
Amarillo, TX 79119-7525
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Another provider at this address
Other student in an organized health care education/training program providers in Canyon
About NPI 1811400666
Tracey Dianne Ecklund's National Provider Identifier is 1811400666, issued on Nov 14, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Canyon, TX. The record was last updated on Nov 14, 2017.