Provider Demographics
NPI:1326084096
Name:DELAPLAIN, TRACEY LANE (MD)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:LANE
Last Name:DELAPLAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6536 S MCCARRAN BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6168
Mailing Address - Country:US
Mailing Address - Phone:775-825-5595
Mailing Address - Fax:775-825-4774
Practice Address - Street 1:6536 S MCCARRAN BLVD
Practice Address - Street 2:STE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6168
Practice Address - Country:US
Practice Address - Phone:775-825-5595
Practice Address - Fax:775-825-4774
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6255207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV32258OtherMEDICARE PTAN
NVNV5959OtherBLUECROSS BLUESHIELD
NVNV5959OtherBLUECROSS BLUESHIELD