Healthcare Provider Details

I. General information

NPI: 1174953814
Provider Name (Legal Business Name): TRACY ANN WARD AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2013
Last Update Date: 11/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE FL 8 UCSF NEUROSURGERY
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

512 FREDERICK ST APT 29
SAN FRANCISCO CA
94117-2734
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7500
  • Fax: 415-353-2889
Mailing address:
  • Phone: 503-358-6956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number23420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: