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NPI Code Detail

MEDICARE: TRACY LEE LEVERONE APRN, BC

MEDICARE: TRACY LEE LEVERONE APRN, BC
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist169947MA

General Provider Information

NPI Number : 1629065818
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY LEE LEVERONE APRN, BC
Provider Business Mailing Address
First Line : 288 BEDFORD ST
Second Line :
City : WHITMAN
State : MA
Zip : 02382-1820
Country : US
Telephone Number : 781-447-6425
Fax Number : 781-447-1786
Provider Business Practice Location Address
First Line : 288 BEDFORD ST
Second Line :
City : WHITMAN
State : MA
Zip : 02382-1820
Country : US
Telephone Number : 781-447-6425
Fax Number : 781-447-1786
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2005
Last Update Date : 01/10/2008

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