Provider Demographics
NPI:1336579697
Name:STONE, TRACEY (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 8571
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-8571
Mailing Address - Country:US
Mailing Address - Phone:855-834-1466
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:330 E PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6435
Practice Address - Country:US
Practice Address - Phone:410-398-3445
Practice Address - Fax:410-620-1538
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0036705163W00000X
DELG-0000720363LF0000X
MDAC001289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse