Provider Demographics
NPI:1447582770
Name:JAMES, TRACY LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6697 SPRINGMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-6412
Mailing Address - Country:US
Mailing Address - Phone:513-895-2065
Mailing Address - Fax:
Practice Address - Street 1:6697 SPRINGMEADOW DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-6412
Practice Address - Country:US
Practice Address - Phone:513-895-2065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 133560164W00000X
OHPN. 133560374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide