Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.019390 | OH |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN.CNP.019390 | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.019390 | OH |
NPI | 1043525629 |
---|---|
Provider Name | Tracy Pankey |
First Address | Liberty Township, OH 45044-8302 |
Second Address | Cincinnati, OH 45240-1464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2010 |
Last Update Date | 04/01/2022 |