Provider Demographics
NPI:1932966306
Name:STONE, TRACIE (CPM)
Entity Type:Individual
Prefix:
First Name:TRACIE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 IVAWOOD RD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-4211
Mailing Address - Country:US
Mailing Address - Phone:205-261-9546
Mailing Address - Fax:
Practice Address - Street 1:888 IVAWOOD RD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-4211
Practice Address - Country:US
Practice Address - Phone:205-261-9546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL172V00000X
174H00000X, 261QB0400X, 374J00000X
UT137348523400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No374J00000XNursing Service Related ProvidersDoula