Provider Demographics
NPI:1972741734
Name:KIRKPATRICK, TRACY MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:MARIE
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5079 DULCE CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8974
Mailing Address - Country:US
Mailing Address - Phone:508-736-2960
Mailing Address - Fax:
Practice Address - Street 1:1616 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3933
Practice Address - Country:US
Practice Address - Phone:401-765-1500
Practice Address - Fax:401-216-3596
Is Sole Proprietor?:No
Enumeration Date:2009-01-31
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH 25994183500000X
FLPS 43161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist