Provider Demographics
NPI:1790102549
Name:ROMEY, TRACY V (CNP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:V
Last Name:ROMEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 ST. ANNE ST.
Mailing Address - Street 2:STE. 100
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701
Mailing Address - Country:US
Mailing Address - Phone:605-348-8000
Mailing Address - Fax:605-348-4315
Practice Address - Street 1:636 ST. ANNE ST.
Practice Address - Street 2:STE. 100
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701
Practice Address - Country:US
Practice Address - Phone:605-348-8000
Practice Address - Fax:605-348-4315
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP000841363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health