Healthcare Provider Details

I. General information

NPI: 1073422150
Provider Name (Legal Business Name): TRACY LYNN SIZEMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2632 WOODMAN CENTER CT
KETTERING OH
45420-1477
US

IV. Provider business mailing address

8444 N 90TH ST STE 100
SCOTTSDALE AZ
85258-4437
US

V. Phone/Fax

Practice location:
  • Phone: 937-739-7100
  • Fax: 480-687-7361
Mailing address:
  • Phone: 602-248-8886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1086947
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1086947
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: