Individual
MRS. TRACY PEARL MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-AGNP
Contact information
Practice address
12960 SHORTLINE HWY, PINE GROVE, WV 26419-8221
(304) 889-3344
(304) 889-3366
Mailing address
12960 SHORTLINE HWY, PINE GROVE, WV 26419-8221
(304) 889-3344
(304) 889-3366
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN53866NP
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821217320
UNKNOWN
WV
Enumeration date
04/11/2014
Last updated
04/21/2022
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