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General NPI Number Information
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NPI Number | 1699778183
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Entity Type | Individual
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Provider Name | TRACIE L. DILLINER CFNP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 604 ANN ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-5122
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Country | US
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Telephone | 304-485-3300
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Fax | 304-485-3616
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Provider Business Mailing Address
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Address Line | 604 ANN ST
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City | PARKERSBURG
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State | WV
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Zip | 26101-5122
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Country | US
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Telephone | 304-485-3300
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Fax | 304-485-3616
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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 | 45818
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License Number State | WV
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