Tracy Lynn McManaway, RN
Individual provider Active NPI Registered Nurse · Kipling, OH
NPI 1164656286 · NPPES record last updated May 4, 2009
Key facts
- NPI
- 1164656286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN303180 (OH)
- Practice address
- 61823 McKinley St
Kipling, OH 43750-0094 - Phone
- (740) 255-0831
- NPI assigned
- May 4, 2009
- 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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN303180 | OH | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN303180 | OH | Yes |
Addresses
Primary practice location
61823 McKinley St
Kipling, OH 43750-0094
Mailing address
61823 McKinley St
PO Box 94
Kipling, OH 43750-0094
Phone (740) 255-0831
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2009. 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.