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TRACEY ANDERSON FNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1841303054

Individual Registrant:
 TRACEY  ANDERSON FNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
25150 HANCOCK AVE STE 210  MURRIETA, CA 92562-5989 US
Tel: 951-587-3739  Fax: 951-698-5213

Contact information for business:
25150 HANCOCK AVE STE 210  MURRIETA, CA 92562-5989 US
Tel: 951-587-3739  Fax: 951-698-5213

Registration Information:
NPI: 1841303054
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
CA95012750
N364SN0800XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
CA95012750
Y363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CA95012750

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
25073567CO05




HEALTH CARE JOBS CA - Page 1



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