Provider Demographics
NPI:1982387999
Name:DILL, TRACY LYNN (APN)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LYNN
Last Name:DILL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 S 1ST RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-8404
Mailing Address - Country:US
Mailing Address - Phone:609-816-6593
Mailing Address - Fax:
Practice Address - Street 1:860 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2018
Practice Address - Country:US
Practice Address - Phone:609-567-0200
Practice Address - Fax:609-567-1951
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14893800208D00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice