Provider Demographics
NPI:1073083242
Name:RAMEY-SHEPPARD, TRACEY (APRN)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:RAMEY-SHEPPARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:RAMEY-SHEPPARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:3225 SABAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2811
Mailing Address - Country:US
Mailing Address - Phone:904-744-8088
Mailing Address - Fax:
Practice Address - Street 1:4738 NORWOOD AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-6152
Practice Address - Country:US
Practice Address - Phone:904-924-9200
Practice Address - Fax:904-924-9203
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily