Healthcare Provider Details

I. General information

NPI: 1437307725
Provider Name (Legal Business Name): TRACY DANIEL-UKINAMEMEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 RESEARCH PKWY STE 205
COLORADO SPRINGS CO
80920-1093
US

IV. Provider business mailing address

7807 ATLANTIC BREEZE LN
RICHMOND TX
77407-4022
US

V. Phone/Fax

Practice location:
  • Phone: 719-445-6242
  • Fax: 719-445-6332
Mailing address:
  • Phone: 646-472-6446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number279881
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1206415
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number221915
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: