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General NPI Number Information
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NPI Number | 1750635504
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Entity Type | Individual
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Provider Name | TRACY ATKINS CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 608 N 1ST ST
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City | ARTESIA
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State | NM
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Zip | 88210-1402
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Country | US
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Telephone | 575-746-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 813 N. WASHINGTON AVE
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City | ROSWELL
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State | NM
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Zip | 88201-3941
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Country | US
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Telephone | 575-622-2606
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | CNP-02071
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License Number State | NM
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