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Tracey Dianne Ecklund
Student in an Organized Health Care Education/Training Program in Canyon, Texas
NPI 1811400666

Tracey Dianne Ecklund is a Student in an Organized Health Care Education/Training Program based in Amarillo, TX. Tracey Dianne Ecklund practices in Canyon, TX. The NPI Number for Tracey Dianne Ecklund is 1811400666 and holds a License No. (Texas).

The current practice location address for Tracey Dianne Ecklund is 2620 Russel Long Blvd, Canyon, TX and can be reached out via phone at 806-651-3640.

Location: 2620 Russel Long Blvd, Canyon, TX, 79119-7525
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811400666
Provider Name
Tracey Dianne Ecklund
Credential
Provider Entity Type
Individual
Gender
Female
Address
2620 Russel Long Blvd, Canyon, TX, 79119-7525
Phone Number
806-651-3640
Fax Number
Provider Enumeration Date
11/14/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2620 Russel Long Blvd
City
Canyon
State
Texas
Zip
79016-0001
Phone Number
806-651-3640
Fax Number
person
Provider Business Mailing Address Details
Address
2620 Russel Long Blvd
City
Canyon
State
Texas
Zip
79016-0001
Phone Number
806-651-3640
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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.
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