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
Phone: (315) 396-5295
Fax: (315) 423-0905
Website:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1700919198 | NPPES |
| New York | MEDICAID | 02625125 |
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