Tracey, Patricia Marie

Tracey, Patricia Marie is an individual health care provider with primary practice located at 263 Farmington Ave General Medicine, Farmington CT 06030-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Tracey, Patricia Marie can be contacted via phone (860) 679-4477.

Contact Information

Primary practice address
263 Farmington Ave General Medicine Farmington CT 06030-0001
Phone: (860) 679-4477
Fax: (860) 679-1025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 004879 Connecticut

Profile Details

NPI number 1124397799
LBN Legal business name Tracey, Patricia Marie
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2011
Last updated Feb 24th, 2012 - 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 1124397799 NPPES
Connecticut MEDICAID 1124977799

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