Provider Demographics
NPI:1750857546
Name:DALE WILLIAMS, TRACYE
Entity Type:Individual
Prefix:MRS
First Name:TRACYE
Middle Name:
Last Name:DALE WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 GLENSHANE PASS
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1976
Mailing Address - Country:US
Mailing Address - Phone:267-250-0683
Mailing Address - Fax:
Practice Address - Street 1:12 READS WAY
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1649
Practice Address - Country:US
Practice Address - Phone:302-323-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0051246163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse