Provider Demographics
NPI:1003823428
Name:ZIELINSKI, TRACY HEATHER (APRN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:HEATHER
Last Name:ZIELINSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:HEATHER
Other - Last Name:ZIELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4219 LEMONGRASS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-8173
Mailing Address - Country:US
Mailing Address - Phone:239-272-7705
Mailing Address - Fax:
Practice Address - Street 1:4219 LEMONGRASS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-8173
Practice Address - Country:US
Practice Address - Phone:239-272-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3217402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105187100Medicaid
P00238118Medicare ID - Type UnspecifiedRAILROAD MEDICARE
Y060GWMedicare ID - Type Unspecified