Individual
TRACY L AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
145 W 23RD ST STE 101, ERIE, PA 16502-2858
(814) 452-2767
(814) 459-2976
Mailing address
145 W 23RD ST STE 101, ERIE, PA 16502-2858
(814) 452-2767
(814) 459-2976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
TP005758B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102262534
—
PA
01
—
CAQH
12227525
—
Enumeration date
12/08/2005
Last updated
04/08/2025
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