Amanda Tracey, M.T.

Primary specialty

Laboratory Management Specialist/TechnologistTaxonomy code 246QL0900X

Practice address

Highway 264, Milepost 388
Laboratory
Polacca, AZ 86042

Phone

(928) 737-6220

Fax

(928) 737-6047

NPI assigned

Apr 7, 2010

Last updated

Apr 7, 2010By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1902121585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "address_2": "LABORATORY",
            "city": "POLACCA",
            "state": "AZ",
            "postal_code": "86034",
            "telephone_number": "928-737-6220",
            "fax_number": "928-737-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 264, MILEPOST 388",
            "address_2": "LABORATORY",
            "city": "POLACCA",
            "state": "AZ",
            "postal_code": "86042",
            "telephone_number": "928-737-6220",
            "fax_number": "928-737-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "AMANDA",
        "name_prefix": "Ms.",
        "credential": "M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0900X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pathology Specialist/Technologist in Polacca, AZ
• Providers in Polacca, AZ by specialty
• Pathology Specialist/Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.