Provider Demographics
NPI:1013216167
Name:MIDWEST APN CONSULTANTS LLC
Entity Type:Organization
Organization Name:MIDWEST APN CONSULTANTS LLC
Other - Org Name:TRACY MURRAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:937-689-5173
Mailing Address - Street 1:640 HEATHERWOODE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1530
Mailing Address - Country:US
Mailing Address - Phone:937-689-5173
Mailing Address - Fax:
Practice Address - Street 1:640 HEATHERWOODE CIR
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1530
Practice Address - Country:US
Practice Address - Phone:937-689-5173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-15
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2338867Medicaid
OH9393961OtherMEDICARE PTAN FOR GROUP