Provider Demographics
NPI:1720125834
Name:ENGLISH, TRACY CAIN (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:CAIN
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E LAKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4930
Mailing Address - Country:US
Mailing Address - Phone:770-217-7575
Mailing Address - Fax:
Practice Address - Street 1:2111 E LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4930
Practice Address - Country:US
Practice Address - Phone:770-217-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA123591363LC1500X, 171M00000X, 363LF0000X
GARN123591363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily