Tracey Ann Tickle, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP012336 Issued in PA

Practice address

6321 Route 30 FL 2
Greensburg, PA 15601-9703

Phone

(724) 671-1750

Fax

(724) 523-7726

NPI assigned

Oct 18, 2012

Last updated

Sep 30, 2020By the provider in NPPES

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

• Tracey Ann Temple Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ttickle261082@direct.ahn.org

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

• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1548513328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6321 ROUTE 30 FL 2",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156019703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6321 ROUTE 30 FL 2",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156019703",
            "telephone_number": "724-671-1750",
            "fax_number": "724-523-7726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 W Crescent Park",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "PA",
            "postal_code": "163652111",
            "country_code": "US",
            "telephone_number": "814-723-3300",
            "fax_number": "814-726-9412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TICKLE",
        "first_name": "TRACEY",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP012336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ttickle261082@direct.ahn.org",
            "affiliation": "N",
            "address_1": "6321 Route 30 Fl 2",
            "city": "Greensburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156019703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "TEMPLE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Greensburg, PA
• Providers in Greensburg, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.