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General NPI Number Information
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NPI Number | 1164258448
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Entity Type | Individual
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Provider Name | TRACEY NICOLE CARDOZA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 21 BRAMBLE BUSH DR
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City | FALMOUTH
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State | MA
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Zip | 02540-2325
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Country | US
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Telephone | 508-457-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 105 JONES RD
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City | FALMOUTH
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State | MA
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Zip | 02540-2903
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Country | US
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Telephone | 617-970-5255
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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 | RN2275780
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License Number State | MA
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