Wilson, Tracey

Wilson, Tracey is an individual health care provider with primary practice located at 29 S Greene St , Baltimore MD 21201-1504. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine. Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine is her primary health care specialty. Wilson, Tracey can be contacted via phone (410) 328-8141.

Contact Information

Primary practice address
29 S Greene St Baltimore MD 21201-1504
Phone: (410) 328-8141
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R115362 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X R115362 Maryland

Profile Details

NPI number 1487828885
LBN Legal business name Wilson, Tracey
Credentials CRNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2008
Last updated Aug 12th, 2015 - about 10 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 1487828885 NPPES
Maryland MEDICAID 419033500
Maryland Other S062-0375
Maryland Other 960542-01 & 02

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