Provider Demographics
NPI:1427531995
Name:JUAREZ, TRACEY ANN (FNP)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:ANN
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 N LAURENT ST STE 250
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5417
Mailing Address - Country:US
Mailing Address - Phone:361-576-0694
Mailing Address - Fax:
Practice Address - Street 1:820 CAMELOT DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8400
Practice Address - Country:US
Practice Address - Phone:956-423-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138270363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care