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Individual

TRACY L ROCKEFELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1258 PURDYTOWN TPKE, LAKEVILLE, PA 18438-6793
(570) 647-9277
(570) 227-0084
Mailing address
1154 BEAVER LAKE DR, LAKE ARIEL, PA 18436-8013
(267) 401-0669

Taxonomy

Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
SP010412
PA
363LA2200X
Adult Health Nurse Practitioner
SP010412
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP010412
PA

Other

Enumeration date
08/13/2009
Last updated
05/28/2024
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