IndividualActive
Tracia a Walters
NPI 1275414823 · Adult Care Home Facility · Rex, GA
Provider details
- NPI number
- 1275414823
- Entity type
- Individual
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 25064627 (GA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
3327 Waggoner Ln
Rex, GA 30273-5220
Phone: (678) 353-7916
Approximate (ZIP-level) locationGet directions
Mailing address
3327 Waggoner Ln
Rex, GA 30273-5220
Registry dates
- Enumerated
- 2025-09-10
- Last updated
- 2025-09-10
- Certified
- 2025-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.