Provider Demographics
NPI:1619028016
Name:ANDREWS, TRACY D (DNP, ACNP)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:D
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:DNP, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 FORT WASHINGTON AVE
Mailing Address - Street 2:7GN 435 MHB
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3733
Mailing Address - Country:US
Mailing Address - Phone:212-305-4980
Mailing Address - Fax:212-305-2439
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:828-262-4103
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006254363LA2100X
PASP008836363LA2100X
NY430342363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098582Medicare ID - Type Unspecified
Q63940Medicare UPIN