Provider Demographics
NPI:1265164222
Name:TRACY, HANNAH JEAN DANGERFIELD (AGPCNP)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:JEAN DANGERFIELD
Last Name:TRACY
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9008 UTE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-8318
Mailing Address - Country:US
Mailing Address - Phone:706-318-1446
Mailing Address - Fax:
Practice Address - Street 1:12650 W 64TH AVE UNIT E501
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3893
Practice Address - Country:US
Practice Address - Phone:303-431-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997673-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology