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Individual

TRACY LYNN DENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
833 CHESTNUT ST STE 701, PHILADELPHIA, PA 19107-4409
(215) 955-0735
(215) 503-9239
Mailing address
833 CHESTNUT ST STE 701, PHILADELPHIA, PA 19107-4409
(215) 955-0735
(215) 503-9239

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP021679
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP021679
PA CRNP LICENSE NUMBER
PA
Enumeration date
03/19/2020
Last updated
03/19/2020
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