Tracy A Allen
Individual provider Active NPI Licensed Practical Nurse · Greenwich, OH
NPI 1356490064 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1356490064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- PN-089609 (OH)
- Practice address
- 1961 Rome Greenwich Rd
Greenwich, OH 44837-9101 - Phone
- (419) 929-9045
- NPI assigned
- Jan 10, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN-089609 | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN-089609 | OH | Yes |
Addresses
Primary practice location
1961 Rome Greenwich Rd
Greenwich, OH 44837-9101
Mailing address
1961 Rome Greenwich Rd
Greenwich, OH 44837-9101
Phone (419) 929-9045
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2390970 | Medicaid | OH |
Other providers in Greenwich, OH
All providers in Greenwich, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.