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NPI Code Detail

MEDICARE: TRACY BONEE APRN

MEDICARE: TRACY BONEE 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
1363LF0000XFamily Nurse Practitioner221401AR

General Provider Information

NPI Number : 1538896196
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY BONEE APRN
Provider Business Mailing Address
First Line : PO BOX 497
Second Line :
City : AUGUSTA
State : AR
Zip : 72006-0497
Country : US
Telephone Number : 870-347-2534
Fax Number :
Provider Business Practice Location Address
First Line : 2450 BATESVILLE BLVD
Second Line :
City : SOUTHSIDE
State : AR
Zip : 72501-7782
Country : US
Telephone Number : 870-569-4934
Fax Number : 870-569-4948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2022
Last Update Date : 01/20/2026

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Directions to “ TRACY BONEE APRN” Practice Location

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