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General NPI Number Information
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NPI Number | 1881657567
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Entity Type | Individual
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Provider Name | TRACY ANNE AGEE ADULT NP
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Gender | Female
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 1830 E MONUMENT ST 8TH FLOOR: GENERAL INTERNAL MEDICINE
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City | BALTIMORE
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State | MD
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Zip | 21287-0020
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Country | US
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Telephone | 443-287-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 1830 E MONUMENT ST 8TH FLOOR: GENERAL INTERNAL MEDICINE
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City | BALTIMORE
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State | MD
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Zip | 21287-0020
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Country | US
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Telephone | 443-287-2030
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R158480
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP30007541
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License Number State | WA
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