Provider Demographics
NPI:1982794954
Name:PAPP-BARNETT, TRACY REVELL (RC, WHNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:REVELL
Last Name:PAPP-BARNETT
Suffix:
Gender:F
Credentials:RC, WHNP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:R
Other - Last Name:PAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3361
Mailing Address - Country:US
Mailing Address - Phone:252-384-2610
Mailing Address - Fax:844-494-0230
Practice Address - Street 1:112 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3361
Practice Address - Country:US
Practice Address - Phone:252-384-2610
Practice Address - Fax:844-494-0230
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166473363LW0102X
NC5005268363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health