TRACEY JOANNE FENDER (NPI# 1275729832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275729832 |
Entity Type | Individual |
Full Name | TRACEY JOANNE FENDER |
Credential | P.N.P. |
Practice Address |
167 North Main St. Tuba City AZ 86045 |
Practice Telephone | 9282832679 |
Mailing Telephone | 9282832679 |
Enumeration Date | 2007-09-18 |
Last Update Date | 2013-05-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
064991-23 | NH | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP2858 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NH | STATE | 064991-23 | 01 |
AZ | AZ STATE BOARD OF NURSING | AP2858 | 01 |
MA | STATE | RN2271333 | 01 |
Street Address |
167 NORTH MAIN ST. |
City | TUBA CITY |
State | AZ |
Zip Code | 86045 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467572685 | Susan Elizabeth Ireland | Registered Nurse | 167 North Main St., Tuba City, AZ 86045 | 2007-03-30 |
1235626177 | Harry Le | Pharmacist | 167 North Main St., Tuba City, AZ 86045 | 2018-04-17 |
1841798220 | Davida Eppes | Pharmacist | 167 North Main St., Tuba City, AZ 86045 | 2018-01-31 |
1003185000 | Monica Lynn Preston | Nurse's Aide | 167 North Main St., Tuba City, AZ 86045-0600 | 2011-12-20 |
1720356926 | Tiffany George | Registered Nurse | 167 North Main St., Tuba City, AZ 86045-0600 | 2011-12-02 |
1619257805 | Mildred Garcia | Registered Nurse | 167 North Main St., Tuba City, AZ 86045-0600 | 2011-08-19 |
1083904205 | Alyson Lawson | Registered Nurse | 167 North Main St., Tuba City, AZ 86045 | 2011-04-08 |
1659672095 | Jeremy Michael Dubinsky | Registered Nurse | 167 North Main St., Tuba City, AZ 86045 | 2010-11-16 |
1568763902 | Laura Faye Gould | Registered Nurse | 167 North Main St., Tuba City, AZ 86045 | 2010-11-16 |
1598066953 | Sharon Burkhart Davis | Registered Nurse | 167 North Main St., Tuba City, AZ 86045-0600 | 2010-11-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
Find all providers in zip 86045 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
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1558961425 | Christian Reese Newsom | Nurse Practitioner | 6980 E Sahuaro Dr Apt 1085, Scottsdale, AZ 85254-5295 | 2020-10-29 |
1083258354 | Stephenie Ann Lechuga | Nurse Practitioner | 3415 W Glendale Ave Ste 32a, Phoenix, AZ 85051-8485 | 2019-10-30 |
1821650201 | Rebekah Ellen Charry | Nurse Practitioner | 115 Calle Portal Ste 700, Sierra Vista, AZ 85635-2950 | 2019-07-05 |
1326606146 | Mollie Finn | Nurse Practitioner | 2356 N Emerald Lake Ct, Tucson, AZ 85749-7925 | 2019-06-05 |
1134698160 | Kayla Rose Percy | Nurse Practitioner | 1205 N F Ave, Douglas, AZ 85607-1920 | 2018-11-20 |
1063987683 | Katherine Anne Bassler | Nurse Practitioner | 5375 E Erickson Dr Ste 103, Tucson, AZ 85712-2838 | 2018-10-10 |
1134613607 | Brittany Kunz | Nurse Practitioner | 2456 E Fairview Cir, Mesa, AZ 85204-5421 | 2018-06-19 |
1124526884 | Kidnurse, LLC | Nurse Practitioner | 1550 S Alma School Rd Ste 275, Mesa, AZ 85210-2107 | 2018-01-29 |
1407354244 | Mariah Karyn White | Nurse Practitioner | 13065 W Mcdowell Rd Ste C130, Avondale, AZ 85392-6448 | 2018-01-26 |
1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.