Jennifer Tracy

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP126482 Issued in TX

Practice address

2350 N Stemmons Fwy Ste 4300MCF4
Dallas, TX 75207-2700

Phone

(214) 456-2444

NPI assigned

Sep 25, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Diane Henderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1316349962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 N STEMMONS FWY STE 4300MCF4",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N STEMMONS FWY STE 4300MCF4",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752072700",
            "telephone_number": "214-456-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP126482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HENDERSON",
            "middle_name": "DIANE",
            "credential": "P.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracey R Adams MD PA
• Tracy E Speight MD PA
• Annika Rose Tracy
• Eryn Tracy, OTD, OTR/L
• Jack Healy Tracy
• Samantha Tracy, MS, RD, LD, CNSC
• Trademark DME, LLC
• Sue Lynn Trafton, M.D.
• Evan Arthur Trahan, MD
• Kathy Copeland Trahan, MD

• Pediatric Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.