Provider Demographics
NPI:1780241778
Name:NEUMAN, TRACEY CHRISTINE (APRN)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:CHRISTINE
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N STEPHANIE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6692
Mailing Address - Country:US
Mailing Address - Phone:702-952-3350
Mailing Address - Fax:702-952-3364
Practice Address - Street 1:1505 WIGWAM PKWY STE 130
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8195
Practice Address - Country:US
Practice Address - Phone:702-856-1400
Practice Address - Fax:702-856-1401
Is Sole Proprietor?:No
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV820345363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner