MEDICARE: TRACY LYNN CARLIN RN

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	363LA2200X	Adult Health Nurse Practitioner	637110	CA

General Provider Information

NPI Number	:	1992641633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY LYNN CARLIN RN

Provider Business Mailing Address
First Line	:	9327 LAKE MURRAY BLVD UNIT E
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1462
Country	:	US
Telephone Number	:	619-838-1145
Fax Number	:

Provider Business Practice Location Address
First Line	:	9327 LAKE MURRAY BLVD UNIT E
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-1462
Country	:	US
Telephone Number	:	619-838-1145
Fax Number	:

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

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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