Provider Demographics
NPI:1649258849
Name:BISHOP DEVANY, TRACY (ARNP)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:
Last Name:BISHOP DEVANY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1813
Mailing Address - Country:US
Mailing Address - Phone:757-412-2709
Mailing Address - Fax:
Practice Address - Street 1:3745 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2847
Practice Address - Country:US
Practice Address - Phone:757-962-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168494363LF0000X
WAARNP 30006389363LF0000X
HIAPRN 769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily