Provider Demographics
NPI:1013263409
Name:TRESKY, TRACY LYNN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:TRESKY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:TRESKY DRUTAROSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:8150 PERRY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5200
Mailing Address - Country:US
Mailing Address - Phone:412-369-9550
Mailing Address - Fax:412-369-9566
Practice Address - Street 1:210 WOODHAVEN DR
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7828
Practice Address - Country:US
Practice Address - Phone:724-779-8741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103572110-0001Medicaid