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Traci Renee Pulliam, DNP
Family Nurse Practitioner in South Bend, Indiana
NPI 1023533890

Traci Renee Pulliam is a Family Nurse Practitioner based in South Bend, IN and is specialized in Family. Traci Renee Pulliam practices in South Bend, IN and has the professional credentials of DNP. The NPI Number for Traci Renee Pulliam is 1023533890 and holds a License No. 71007505A (Indiana).

The current practice location address for Traci Renee Pulliam is 615 N Michigan St Fl 4, South Bend, IN and can be reached out via phone at 574-647-6892 and via fax at 574-647-6895.

Location: 615 N Michigan St Fl 4, South Bend, IN, 46617-1924
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Provider Profile Details
NPI Number
1023533890
Provider Name
Traci Renee Pulliam
Credential
DNP
Provider Entity Type
Individual
Gender
Female
Address
615 N Michigan St Fl 4, South Bend, IN, 46617-1924
Phone Number
574-647-6892
Fax Number
574-647-6895
Provider Enumeration Date
08/13/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
300007557 05 IN
259900012 01 IN MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
615 N Michigan St Fl 4
City
State
Zip
46601-1033
Phone Number
574-647-6892
Fax Number
574-647-6895
person
Provider Business Mailing Address Details
Address
615 N Michigan St Fl 4
City
State
Zip
46601-1033
Phone Number
574-647-6892
Fax Number
574-647-6895
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71007505A (Indiana)
Definition
Definition to come...
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