Provider Demographics
NPI:1811729643
Name:MORRIS-JOINER, TRACY LASHAWN
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LASHAWN
Last Name:MORRIS-JOINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 W 86TH ST STE 310
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1781
Mailing Address - Country:US
Mailing Address - Phone:317-590-3925
Mailing Address - Fax:
Practice Address - Street 1:3901 W 86TH ST STE 310
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1781
Practice Address - Country:US
Practice Address - Phone:317-590-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN347C00000X, 174200000X, 372600000X, 347C00000X, 372600000X, 253Z00000X
374U00000X, 385H00000X, 385HR2065X
IN24-0179903747P1801X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No174200000XOther Service ProvidersMeals
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child