Provider Demographics
NPI:1699850503
Name:MCKINNEY, TRACEY LEVONE (NNP)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:LEVONE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:LEVONE
Other - Last Name:DOWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:501 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4634
Mailing Address - Country:US
Mailing Address - Phone:727-767-4313
Mailing Address - Fax:727-767-4391
Practice Address - Street 1:501 6TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4634
Practice Address - Country:US
Practice Address - Phone:727-767-4313
Practice Address - Fax:727-767-4391
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001172363LN0000X
TX566577363LN0005X
NVRN54886363LN0005X
FLAPRN2058072363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care