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General NPI Number Information
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NPI Number | 1962361907
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Entity Type | Individual
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Provider Name | TRACY C WYANT RN, AOCN, GERO-BC
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Gender | Female
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 7304 MORNING STAR TRL
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City | SAGAMORE HILLS
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State | OH
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Zip | 44067-3504
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Country | US
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Telephone | 330-651-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 7304 MORNING STAR TRL
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City | SAGAMORE HILLS
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State | OH
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Zip | 44067-3504
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Country | US
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Telephone | 330-651-5288
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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 | 364SX0200X
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Taxonomy Name | Oncology Clinical Nurse Specialist
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License Number | RN-205528
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License Number State | OH
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