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NPI Code Detail

MEDICARE: TRACEE L MATINCHECK CRNP

MEDICARE: TRACEE L MATINCHECK CRNP
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
1363L00000XNurse PractitionerSP016306PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568812568
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEE L MATINCHECK CRNP
Provider Business Mailing Address
First Line : 1025 W HARRISBURG PIKE
Second Line :
City : MIDDLETOWN
State : PA
Zip : 17057-4848
Country : US
Telephone Number : 717-944-0491
Fax Number : 717-944-1436
Provider Business Practice Location Address
First Line : 1025 W HARRISBURG PIKE
Second Line :
City : MIDDLETOWN
State : PA
Zip : 17057-4848
Country : US
Telephone Number : 717-944-0491
Fax Number : 717-944-1436
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2016
Last Update Date : 01/28/2021

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Directions to “ TRACEE L MATINCHECK CRNP” Practice Location

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