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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
041-194691ILMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Board Members-Crawford County Government Past Accepting new patients
Crawford County Health Department Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Robinson, IL · Administrator Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.