Provider Demographics
NPI:1922241538
Name:VITORI, TRACEY ANN (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:ANN
Last Name:VITORI
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 SMITH RD
Mailing Address - Street 2:STE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1974
Mailing Address - Country:US
Mailing Address - Phone:513-245-3663
Mailing Address - Fax:513-475-7259
Practice Address - Street 1:2368 VICTORY PKWY STE 501
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2850
Practice Address - Country:US
Practice Address - Phone:513-298-8271
Practice Address - Fax:513-872-7385
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.10633363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100126900Medicaid
OH3091318Medicaid
OHNP36581Medicare PIN