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General NPI Number Information
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NPI Number | 1790411213
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Entity Type | Individual
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Provider Name | TRACEY NEARON
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Gender | Female
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 8333 ALEXANDRIA PIKE
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City | ALEXANDRIA
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State | KY
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Zip | 41001-1187
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Country | US
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Telephone | 859-694-4000
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Fax | 859-694-4200
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Provider Business Mailing Address
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Address Line | 8333 ALEXANDRIA PIKE
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City | ALEXANDRIA
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State | KY
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Zip | 41001-1187
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Country | US
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Telephone | 859-694-4000
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Fax | 859-694-4200
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0031709
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3018082
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License Number State | KY
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