Provider Demographics
NPI:1043410426
Name:BEGLEY, TRACEY (CNP)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:BEGLEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 GIBBS ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2801
Mailing Address - Country:US
Mailing Address - Phone:419-893-7134
Mailing Address - Fax:419-893-6942
Practice Address - Street 1:625 GIBBS ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-2801
Practice Address - Country:US
Practice Address - Phone:419-893-7134
Practice Address - Fax:419-893-6942
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN266541363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology