Provider Demographics
NPI:1952698565
Name:MOUNT, TRACY LYNN (APN-C)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:MOUNT
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW EGYPT
Mailing Address - State:NJ
Mailing Address - Zip Code:08533-2525
Mailing Address - Country:US
Mailing Address - Phone:609-509-4489
Mailing Address - Fax:609-710-0971
Practice Address - Street 1:263 LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW EGYPT
Practice Address - State:NJ
Practice Address - Zip Code:08533-2525
Practice Address - Country:US
Practice Address - Phone:609-758-9077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00328600363LP0808X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health