Provider Demographics
NPI:1942632898
Name:SOKOLOSKI, TRACY LEE (CRNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LEE
Last Name:SOKOLOSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-2401
Mailing Address - Country:US
Mailing Address - Phone:570-343-2383
Mailing Address - Fax:570-343-3923
Practice Address - Street 1:501 MADISON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2401
Practice Address - Country:US
Practice Address - Phone:570-343-2383
Practice Address - Fax:570-343-3923
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013170363LF0000X
PARN578153163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse