Provider Demographics
NPI:1306543384
Name:LINNEY, TRACIE LEQUETTE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:TRACIE
Middle Name:LEQUETTE
Last Name:LINNEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:TRACIE
Other - Middle Name:LEQUETTE
Other - Last Name:BOWIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2027 COPPER LEAF PKWY APT 202
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-7769
Mailing Address - Country:US
Mailing Address - Phone:248-648-5539
Mailing Address - Fax:
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF07201061207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease