Provider Demographics
NPI:1891101754
Name:GREER, TRACY PAPATHAKIS (FNP-BC, RN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:PAPATHAKIS
Last Name:GREER
Suffix:
Gender:F
Credentials:FNP-BC, RN
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:ANNE
Other - Last Name:PAPATHAKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:230 PROSPECT PL STE 220
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1978
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 PROSPECT PL STE 220
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1978
Practice Address - Country:US
Practice Address - Phone:619-522-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002226363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily