Provider Demographics
NPI:1114636990
Name:RINE-COLE, TRACY COLLEEN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:COLLEEN
Last Name:RINE-COLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 CUNNINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49325-9425
Mailing Address - Country:US
Mailing Address - Phone:269-317-3142
Mailing Address - Fax:
Practice Address - Street 1:1221 M 89 STE 200
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1180
Practice Address - Country:US
Practice Address - Phone:269-680-3710
Practice Address - Fax:269-225-1313
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704196598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily