Provider Demographics
NPI:1417499229
Name:NELSON, TRACY (OTA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:UNC HOSPITALS REHAB THERAPY DEPARTMENT
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:984-974-5300
Mailing Address - Fax:984-974-5305
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:UNC HOSPITALS REHAB THERAPY DEPARTMENT
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:984-974-5300
Practice Address - Fax:984-974-5305
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10149224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant