Fender, Tracey Joanne

Fender, Tracey Joanne is an individual health care provider with primary practice located at 167 North Main St. , Tuba City AZ 86045. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Fender, Tracey Joanne can be contacted via phone (928) 283-2679.

Contact Information

Primary practice address
167 North Main St. Tuba City AZ 86045
Phone: (928) 283-2679
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP2858 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 064991-23 New Hampshire

Profile Details

NPI number 1275729832
LBN Legal business name Fender, Tracey Joanne
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 18th, 2007
Last updated May 16th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275729832 NPPES
Massachusetts Other RN2271333 STATE
Massachusetts Other AP2858 STATE
Massachusetts Other 064991-23 STATE

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