Provider Demographics
NPI:1184726440
Name:SHEARER, TRACEY ANN (RPH)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:ANN
Last Name:SHEARER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DICKEN DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17053-9702
Mailing Address - Country:US
Mailing Address - Phone:717-957-0146
Mailing Address - Fax:
Practice Address - Street 1:3180 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:PA
Practice Address - Zip Code:17315-4512
Practice Address - Country:US
Practice Address - Phone:717-767-5322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04-105066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist