Provider Demographics
NPI:1932458346
Name:LEAR, TRACIE LYNN (APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:TRACIE
Middle Name:LYNN
Last Name:LEAR
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:TRACIE
Other - Middle Name:LYNN
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, NP-C
Mailing Address - Street 1:740 S LIMESTONE ST PERIOPERATIVE SERVICES
Mailing Address - Street 2:SUITE J111
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0200
Mailing Address - Country:US
Mailing Address - Phone:859-323-7691
Mailing Address - Fax:859-323-3704
Practice Address - Street 1:740 S LIMESTONE ST PERIOPERATIVE SERVICES
Practice Address - Street 2:SUITE J111
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0200
Practice Address - Country:US
Practice Address - Phone:859-323-7691
Practice Address - Fax:859-323-3704
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3007517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily