Tracy George, RN
Individual provider Active NPI Registered Nurse · Clinton, LA
NPI 1164052320 · NPPES record last updated Jan 16, 2020
Key facts
- NPI
- 1164052320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN104772 (LA)
- Practice address
- 11990 Jackson St
Clinton, LA 70722-3210 - Phone
- (225) 683-5292
- Fax
- (225) 683-1310
- NPI assigned
- Jan 16, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN104772 | LA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN104772 | LA | Yes |
Addresses
Primary practice location
11990 Jackson St
Clinton, LA 70722-3210
Mailing address
PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN104772 | Other | LA | RN LICENSE |
Other providers in Clinton, LA
- Joy L Gardner
- Jillian Gautier
- Shannon C Gavin
- Natasha Danielle Gay
- Wimberly Reeves Gayle
- Alison Gifford
- Darie S. Gilliam
- Laresha Gilmore
- Lashadra Gilmore
- Jessica Fae Golden-Cooper
All providers in Clinton, LA · Registered Nurse in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.