Darla K. Tracy, CPHA
Individual provider Active NPI Administrator Registered Nurse · Robinson, IL
NPI 1386908549 · NPPES record last updated Jul 2, 2012
Key facts
- NPI
- 1386908549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Administrator Registered Nurse 163WA2000X
- License
- 041-194691 (IL)
- Practice address
- 202 N Bline Blvd
Robinson, IL 62454-1264 - Phone
- (618) 544-8798
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 041-194691 | IL | MD | Administrator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board Members-Crawford County Government | Past | Accepting new patients | |
| Crawford County Health Department | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 041-194691 | IL | Yes |
Addresses
Primary practice location
202 N Bline Blvd
Robinson, IL 62454-1264
Mailing address
7712 E Westlake Dr
Robinson, IL 62454-4879
Phone (618) 544-9273
Other providers in Robinson, IL
- Gary A Tennison
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- Morgan Thomas
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- Union Associated Physicians Clinic, LLC
- United Life Care Amb SVC Inc
- Lindsey Hope Vanschoyck
- Sharon Jamandron Vidal
All providers in Robinson, IL · Administrator Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2012. 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.