Provider Demographics
NPI:1982419669
Name:PRICE, TRACY ANNE
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANNE
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:ANNE
Other - Last Name:CUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13805 S 49TH ST
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-2811
Mailing Address - Country:US
Mailing Address - Phone:402-312-0756
Mailing Address - Fax:
Practice Address - Street 1:13805 S 49TH ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-2811
Practice Address - Country:US
Practice Address - Phone:402-312-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion