Provider Demographics
NPI:1467493056
Name:JONES, TRACI L (NP)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:L
Last Name:JONES
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 E APPLE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-4413
Mailing Address - Country:US
Mailing Address - Phone:231-798-4445
Mailing Address - Fax:231-798-4462
Practice Address - Street 1:2734 E APPLE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-4413
Practice Address - Country:US
Practice Address - Phone:231-798-4445
Practice Address - Fax:231-798-4462
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704199363363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4636659Medicaid