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General NPI Number Information
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NPI Number | 1881430437
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Entity Type | Individual
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Provider Name | TRACY LITTLE PRITCHARD APRN
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Gender | Female
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Dates
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Enumeration Date | 07/03/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 4565 US HIGHWAY 17 STE 106
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4822
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Country | US
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Telephone | 904-269-4559
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Fax | 904-269-4597
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 904-745-3618
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Fax | 904-722-4271
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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 | RN203700
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11033614
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License Number State | FL
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