Provider Demographics
NPI:1700073764
Name:CROOK, TRACY W (LPN, CFA)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:W
Last Name:CROOK
Suffix:
Gender:F
Credentials:LPN, CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PENN ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1956
Mailing Address - Country:US
Mailing Address - Phone:717-646-1117
Mailing Address - Fax:717-632-4748
Practice Address - Street 1:100 PENN ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1956
Practice Address - Country:US
Practice Address - Phone:717-646-1117
Practice Address - Fax:717-632-4748
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN076172L246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant