Provider Demographics
NPI:1104312321
Name:CLOUD, TRACY LYNNE (RN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNNE
Last Name:CLOUD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 E TYLER AVE STE G
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7109
Mailing Address - Country:US
Mailing Address - Phone:956-425-0606
Mailing Address - Fax:956-425-0620
Practice Address - Street 1:1906 E TYLER AVE STE G
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7109
Practice Address - Country:US
Practice Address - Phone:956-425-0606
Practice Address - Fax:956-425-0620
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX737394163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health