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NPI Code Detail

MEDICARE: MRS. TRACIE LYNN ROBERTS FNP-BC

MEDICARE: MRS. TRACIE LYNN ROBERTS FNP-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
1163WS0200XSchool Registered NurseL10027141DE
2363LF0000XFamily Nurse PractitionerLG-0000596DE

General Provider Information

NPI Number : 1871637694
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACIE LYNN ROBERTS FNP-BC
Provider Business Mailing Address
First Line : 23557 WILLOW DR
Second Line :
City : MILLSBORO
State : DE
Zip : 19966-2891
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20251 JOHN J WILLIAMS HWY
Second Line :
City : LEWES
State : DE
Zip : 19958-4314
Country : US
Telephone Number : 302-644-6860
Fax Number : 302-644-6872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 05/03/2022

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Directions to “ MRS. TRACIE LYNN ROBERTS FNP-BC” Practice Location

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