Provider Demographics
NPI:1689368136
Name:HARSH, TRACY RENEE (RN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:RENEE
Last Name:HARSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8859 BEAGLE CLUB LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-2089
Mailing Address - Country:US
Mailing Address - Phone:301-573-9021
Mailing Address - Fax:
Practice Address - Street 1:13302 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2675
Practice Address - Country:US
Practice Address - Phone:240-513-3590
Practice Address - Fax:301-797-4975
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134799163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational HealthGroup - Single Specialty