Provider Demographics
NPI:1558554089
Name:CHRISTOPHER, TRACY L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:L
Last Name:CHRISTOPHER
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 1:36 N MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2701
Mailing Address - Country:US
Mailing Address - Phone:740-773-5539
Mailing Address - Fax:
Practice Address - Street 1:36 N MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2701
Practice Address - Country:US
Practice Address - Phone:740-773-5539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 124779164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse