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General NPI Number Information
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NPI Number | 1013545656
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Entity Type | Individual
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Provider Name | TRACEY LONG CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 524 S WASHINGTON ST
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City | GETTYSBURG
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State | PA
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Zip | 17325-2594
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Country | US
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Telephone | 717-334-2183
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Fax |
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Provider Business Mailing Address
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Address Line | 3132 OLD TANEYTOWN RD
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City | WESTMINSTER
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State | MD
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Zip | 21158-2537
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Country | US
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Telephone | 443-536-1760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP021732
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License Number State | PA
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