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General NPI Number Information
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NPI Number | 1487783114
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Entity Type | Individual
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Provider Name | TRACEY ANN WERTHEIM ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5400 SCHOOL ROAD COMPANY CARE
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652
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Country | US
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Telephone | 727-834-5908
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Fax | 727-834-5680
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Provider Business Mailing Address
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Address Line | 2130 OVERVIEW DRIVE
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655
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Country | US
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Telephone | 727-376-1516
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Fax | 727-376-1532
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1522082
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License Number State | FL
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