Provider Demographics
NPI:1518208693
Name:QUINN-HANSMAN, TRACY E (FNP)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:E
Last Name:QUINN-HANSMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 DEMOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1811
Mailing Address - Country:US
Mailing Address - Phone:516-764-3070
Mailing Address - Fax:
Practice Address - Street 1:384 DEMOTT AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1811
Practice Address - Country:US
Practice Address - Phone:516-764-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337283-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily