Leach, Tracy
Leach, Tracy is an individual health care provider with primary practice located at 707 Hollybrook Dr , Longview TX 75605-2410. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care, which is considered as her primary health care specialty. Leach, Tracy can be contacted via phone (903) 757-6042.Contact Information
Primary practice address
707 Hollybrook Dr
Longview TX 75605-2410
Phone: (903) 757-6042
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Neonatal, Critical Care | 363LN0005X | AP124269 | Texas |
Profile Details
| NPI number | 1144662032 |
|---|---|
| LBN Legal business name | Leach, Tracy |
| Credentials | NNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 22nd, 2013 |
| Last updated | May 19th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144662032 | NPPES |
| Texas | MEDICAID | 325841004 | |
| Texas | Other | 75-2616977-042 | |
| Texas | Other | P01813068 | |
| Texas | Other | 8401MC |
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