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General NPI Number Information
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NPI Number | 1821474446
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Entity Type | Individual
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Provider Name | TRACY MICHELLE LAKIN CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 930 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4312
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Country | US
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Telephone | 256-519-8104
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Fax | 256-519-8327
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Provider Business Mailing Address
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Address Line | 4601 WHITESBURG DR SE STE 201
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1678
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Country | US
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Telephone | 256-880-1050
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Fax | 256-213-4681
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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 | 1-079663
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-079663
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License Number State | AL
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