Provider Demographics
NPI:1962588244
Name:AVERY-GETER, TRACEY LYN (NP)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:LYN
Last Name:AVERY-GETER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E CARY ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-3816
Mailing Address - Country:US
Mailing Address - Phone:804-482-5479
Mailing Address - Fax:804-786-9021
Practice Address - Street 1:400 E CARY ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-3816
Practice Address - Country:US
Practice Address - Phone:804-482-5479
Practice Address - Fax:804-786-9021
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167176363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA201848187Medicare PIN