Tracey Lee Loudon, MN, RN, CNS, CCNS

Individual provider Active NPI Acute Care Clinical Nurse Specialist · Boring, OR

NPI 1154631612 · NPPES record last updated Oct 18, 2010

Key facts

NPI
1154631612
Entity type
Individual (NPI type 1)
Primary specialty
Acute Care Clinical Nurse Specialist 364SA2100X
License
201070010CNS (OR)
Practice address
32100 SE Chin St
Boring, OR 97009-9776
Phone
(503) 663-0295
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201070010CNSORMDClinical Nurse Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 201070010CNS OR
Acute Care Clinical Nurse Specialist 364SA2100X 201070010CNS OR Yes

Addresses

Primary practice location

32100 SE Chin St
Boring, OR 97009-9776

Mailing address

32100 SE Chin St
Boring, OR 97009-9776
Phone (503) 663-0295

Other names

  • Tracey Lee Conner Former name

Other providers in Boring, OR

All providers in Boring, OR · Acute Care Clinical Nurse Specialist in Oregon

Sources for this page

Verify at the official NPI Registry.