Provider Demographics
NPI:1255515359
Name:RAMOS, TRACY ANN
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 TURNPIKE ST STE 25
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5937
Mailing Address - Country:US
Mailing Address - Phone:978-290-4646
Mailing Address - Fax:978-290-4822
Practice Address - Street 1:575 TURNPIKE ST STE 25
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5937
Practice Address - Country:US
Practice Address - Phone:978-290-4646
Practice Address - Fax:978-290-4822
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198648363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0716740Medicaid
MANP9384OtherBLUE CROSS
MA0716740Medicaid