Provider Demographics
NPI:1245600436
Name:ROBBINS, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:L
Other - Last Name:BATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O BOX 305
Mailing Address - Street 2:P.O BOX 305,
Mailing Address - City:MILBRIDGE
Mailing Address - State:ME
Mailing Address - Zip Code:04658
Mailing Address - Country:US
Mailing Address - Phone:207-546-2410
Mailing Address - Fax:
Practice Address - Street 1:1037 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:STEUBEN
Practice Address - State:ME
Practice Address - Zip Code:04680-2931
Practice Address - Country:US
Practice Address - Phone:207-546-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0000000000172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker