Provider Demographics
NPI:1720451545
Name:RAPP, TRACY W (DNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:W
Last Name:RAPP
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000, DEPT 978
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-320-6915
Mailing Address - Fax:901-320-6920
Practice Address - Street 1:3473 POPLAR AVE STE 103
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4654
Practice Address - Country:US
Practice Address - Phone:901-320-6915
Practice Address - Fax:901-320-6920
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20344363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily