Individual
TRACY MARIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4917
(317) 988-4929
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4917
(317) 988-4929
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71003170A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71003170B
IN
363LW0102X
Women's Health Nurse Practitioner
28143782A
IN
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
28143782A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71003170A
APN PRES AUTHORITY
—
Enumeration date
03/31/2008
Last updated
09/26/2022
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