Provider Demographics
NPI:1164819918
Name:CONBOY, TRACY (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:CONBOY
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 E BUTHERUS DR STE 9
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2523
Mailing Address - Country:US
Mailing Address - Phone:602-377-7326
Mailing Address - Fax:480-499-5526
Practice Address - Street 1:8160 E BUTHERUS DR STE 9
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2523
Practice Address - Country:US
Practice Address - Phone:602-377-7326
Practice Address - Fax:480-499-5526
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7751363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health