Provider Demographics
NPI:1669968335
Name:HEDINE, TRACY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:HEDINE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 LAZY MORNING PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3213
Mailing Address - Country:US
Mailing Address - Phone:281-939-5345
Mailing Address - Fax:
Practice Address - Street 1:1120 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3242
Practice Address - Country:US
Practice Address - Phone:281-528-4100
Practice Address - Fax:281-528-4099
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily