Provider Demographics
NPI:1649558255
Name:ARTHUR, TRACY LEIGH (ANP-BC, RN, BSN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LEIGH
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:ANP-BC, RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:1300 W BROAD ST
Mailing Address - Street 2:P.O. 842022
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23284-9089
Mailing Address - Country:US
Mailing Address - Phone:804-828-8828
Mailing Address - Fax:
Practice Address - Street 1:1300 W BROAD ST
Practice Address - Street 2:P.O. 842022
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23284-9089
Practice Address - Country:US
Practice Address - Phone:804-828-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001212724163W00000X
VA0024169482363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse