NPIMap

Organization Active NPI

Tracie L Dubose FNP LLC

  • Family Medicine Physician
  • Eunice, LA
National Provider Identifier
1700159175
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP06739 Issued in LA
Legal business name
TRACIE L DUBOSE FNP LLC
Practice address
281 Moosa Blvd
Eunice, LA 70535-3638
Phone
(337) 457-2200
Fax
(337) 457-2203
NPI assigned
Feb 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Tracie L Dubose, CFNP
Title
President
Phone
(337) 457-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AP06739 LA Primary

Addresses

Primary practice location

281 Moosa Blvd
Eunice, LA 70535-3638

Mailing address

281 Moosa Blvd
Eunice, LA 70535-3638
Phone (337) 457-2200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1700159175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353638",
            "telephone_number": "337-457-2200",
            "fax_number": "337-457-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 MOOSA BLVD",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353638",
            "telephone_number": "337-457-2200",
            "fax_number": "337-457-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACIE L DUBOSE FNP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-457-2200",
        "authorized_official_credential": "CFNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "AP06739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.