Healthcare Provider Details

I. General information

NPI: 1740467331
Provider Name (Legal Business Name): TRACY COLLINS BOYLE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DICKINSON DR STE 107
CHADDS FORD PA
19317-9689
US

IV. Provider business mailing address

PO BOX 306704
NASHVILLE TN
37230-6704
US

V. Phone/Fax

Practice location:
  • Phone: 610-361-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP029777
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP005249B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: