Provider Demographics
NPI:1366501454
Name:RENTNER, TRACY L (RNC-FNP)
Entity Type:Individual
Prefix:MISS
First Name:TRACY
Middle Name:L
Last Name:RENTNER
Suffix:
Gender:F
Credentials:RNC-FNP
Other - Prefix:MRS
Other - First Name:TRACY
Other - Middle Name:L
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7011 FAYETTEVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7745
Practice Address - Country:US
Practice Address - Phone:919-361-2644
Practice Address - Fax:919-484-0849
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5001026363L00000X, 363LF0000X
NC0050-01026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP26443Medicare UPIN