Provider Demographics
NPI:1760407589
Name:STRICKER, TRACY LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:STRICKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:520-519-7700
Mailing Address - Fax:
Practice Address - Street 1:13555 W MCDOWELL RD STE 206
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2626
Practice Address - Country:US
Practice Address - Phone:623-487-4822
Practice Address - Fax:623-334-9881
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1589363L00000X
AZRN117748363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ352514Medicaid
Z170680OtherMEDICARE
AZP00742747OtherRAILROAD MEDICARE
AZZ121655Medicare UPIN