Healthcare Provider Details

I. General information

NPI: 1508020777
Provider Name (Legal Business Name): TRACY DILLINGHAM CNP / CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8020 LIBERTY WAY
WEST CHESTER OH
45069-2519
US

IV. Provider business mailing address

8020 LIBERTY WAY
WEST CHESTER OH
45069-2519
US

V. Phone/Fax

Practice location:
  • Phone: 513-463-4300
  • Fax: 513-463-4310
Mailing address:
  • Phone: 513-463-4300
  • Fax: 513-463-4310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.13917-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNM-11023
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCOA.10023-NM
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.13917
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: