Provider Demographics
NPI:1558971267
Name:ROZUM, TRACEE J (CRNP)
Entity Type:Individual
Prefix:
First Name:TRACEE
Middle Name:J
Last Name:ROZUM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2494 BERNVILLE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9467
Mailing Address - Country:US
Mailing Address - Phone:610-378-2676
Mailing Address - Fax:610-378-2679
Practice Address - Street 1:2494 BERNVILLE RD STE 207
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9467
Practice Address - Country:US
Practice Address - Phone:610-378-2676
Practice Address - Fax:610-378-2679
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022144363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care