Traci Wilson

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

T11798 Issued in MD

Practice address

2384 Brandermill Blvd
Gambrills, MD 21054-1850

Phone

(443) 302-6279

Fax

(443) 302-6289

NPI assigned

Feb 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Traci Boehm Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1346630969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2384 BRANDERMILL BLVD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541850",
            "telephone_number": "443-302-6297",
            "fax_number": "443-302-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2384 BRANDERMILL BLVD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541850",
            "telephone_number": "443-302-6279",
            "fax_number": "443-302-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TRACI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MD",
            "license": "T11798",
            "primary": true
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CA",
            "license": "118732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "BOEHM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Katherine Wendt, PTA
• Brittany Nicole Wenschhof, PT, DPT
• Rachel Wilhide
• William a Gormley DPM LLC
• Melissa Marie Wilson, RN, IBCLC
• Christopher Thomas Wood
• Michelle Elise Woods, DDS
• Kenny Wu
• Dan Yang, DDS
• Olivia Zambruno

• Pharmacy Technician in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Pharmacy Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.