Provider Demographics
NPI:1972354116
Name:PERSON, TRACY C (DOULA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:C
Last Name:PERSON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9209 MEADOW LANE CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2298
Mailing Address - Country:US
Mailing Address - Phone:718-916-5856
Mailing Address - Fax:
Practice Address - Street 1:4819 E BUSCH BLVD STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-6096
Practice Address - Country:US
Practice Address - Phone:718-916-5856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula