MEDICARE: TRACY PANKEY APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN.CNP.019390	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.019390	OH
3	163WH0200X	Home Health Registered Nurse	RN348898	OH
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.019390	OH

General Provider Information

NPI Number	:	1043525629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY PANKEY APRN

Provider Business Mailing Address
First Line	:	7419 KINGSGATE WAY STE E
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6517
Country	:	US
Telephone Number	:	513-818-6992
Fax Number	:	513-812-7754

Provider Business Practice Location Address
First Line	:	7419 KINGSGATE WAY STE E
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6517
Country	:	US
Telephone Number	:	513-818-6992
Fax Number	:	513-812-7754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2010
Last Update Date	:	06/23/2026

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