Provider Demographics
NPI:1831743095
Name:CARRAGGI, TRACY LYNN (MSN,RN, AGACNP, APRN)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:CARRAGGI
Suffix:
Gender:F
Credentials:MSN,RN, AGACNP, APRN
Other - Prefix:MRS
Other - First Name:TRACY
Other - Middle Name:LYNN
Other - Last Name:CARRAGGI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGACNP, APRN
Mailing Address - Street 1:63 EDDIE DOWLING HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-7322
Mailing Address - Country:US
Mailing Address - Phone:401-769-2222
Mailing Address - Fax:401-769-4555
Practice Address - Street 1:63 EDDIE DOWLING HWY
Practice Address - Street 2:
Practice Address - City:NORTH SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-7322
Practice Address - Country:US
Practice Address - Phone:401-769-2222
Practice Address - Fax:401-769-4555
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-26
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02105363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care