Mowry, Traci Ann

Mowry, Traci Ann is an sole proprietor health care provider with primary practice located at 1350 Oak Street , Syracuse NY 13203. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Mowry, Traci Ann can be contacted via phone (315) 396-5295.

Contact Information

Primary practice address
1350 Oak Street Syracuse NY 13203
Fax: (315) 423-0905
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 270388 New York

Profile Details

NPI number 1700919198
LBN Legal business name Mowry, Traci Ann
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 14th, 2007
Last updated Jul 8th, 2007 - about 17 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 1700919198 NPPES
New York MEDICAID 02625125

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