Provider Demographics
NPI:1063977643
Name:FERSHEE, TRACY A (NP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:A
Last Name:FERSHEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:ROBLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:111 E DUNLAP AVE STE 1-273
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-7801
Mailing Address - Country:US
Mailing Address - Phone:480-867-7225
Mailing Address - Fax:602-674-6253
Practice Address - Street 1:9225 N 3RD ST STE 205
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2464
Practice Address - Country:US
Practice Address - Phone:480-867-7223
Practice Address - Fax:480-569-2967
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ218697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ218697OtherARIZONA NURSING BOARD