TRACI WILSON (NPI# 1346630969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346630969 |
| Entity Type | Individual |
| Full Name | TRACI WILSON |
| Other Name | TRACI BOEHM |
| Practice Address |
2384 Brandermill Blvd Gambrills MD 21054-1850 |
| Practice Telephone | 4433026279 |
| Practice Fax Number | 4433026289 |
| Mailing Telephone | 4433026297 |
| Mailing Fax Number | 4433026289 |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183700000X | Pharmacy Technician | 118732 | CA | Pharmacy Service Providers |
| Y | 183700000X | Pharmacy Technician | T11798 | MD | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427549617 | Traci Denise Wilson | Registered Nurse | 7419 Drumlea Rd, Capitol Heights, MD 20743-3423 | 2018-05-23 |
| 1750304291 | Traci Breniser Wilson | Psychologist | 225 South Main St, Suite B, Brooklyn, MI 49230 | 2006-07-25 |
| 1609365287 | Traci Carol Wilson | Licensed Practical Nurse | 65 Saint Francis Ave, Tiffin, OH 44883-3413 | 2018-05-09 |
| 1477914935 | Traci Wilson | Nurse Practitioner | 6040 University Town Centre Dr, Morgantown, WV 26501-2421 | 2016-03-11 |
| 1457751992 | Traci Wilson | Counselor | 3480 Buskirk Ave, Suite 210, Pleasant Hill, CA 94523-4341 | 2014-09-03 |
| 1073841664 | Traci L Wilson | Acupuncturist | 45 E Loucks St, Suite 014, Sheridan, WY 82801-6339 | 2009-11-19 |
| 1215129937 | Traci Wilson | Licensed Practical Nurse | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 | 2007-08-16 |
| Street Address |
2384 BRANDERMILL BLVD |
| City | GAMBRILLS |
| State | MD |
| Zip Code | 21054-1850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235409889 | Maryland Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2012-01-12 |
| 1083259477 | Farid Israel | Pharmacist | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2019-11-09 |
| 1245622257 | Youngeun Kim | Pharmacist | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2015-02-27 |
| 1891103917 | Elizabeth Rosenberger | Pharmacist | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2014-08-01 |
| 1548603244 | Melinda Randolph | Pharmacist | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2013-04-11 |
| 1982944427 | Darren Michael Moulden | Pharmacist | 2384 Brandermill Blvd, Gambrills, MD 21054-1850 | 2013-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447925 | Maksim Simakhodskiy | Massage Therapist | 1328 Waugh Chapel Way, Gambrills, MD 21054 | 2020-11-02 |
| 1013515154 | Ls Creative Agency LLC | Durable Medical Equipment & Medical Supplies | 1153 Route 3 North, Suite 10, Gambrills, MD 21054 | 2020-10-12 |
| 1710510540 | Mijeong Joo-bunyard | Physical Therapist | 1153 Md-3n, Suite 35, Gambrills, MD 21054 | 2020-02-20 |
| 1144873043 | Sadia Cheema | Nurse Practitioner | 1071 Md-3 North, Suite 101, Gambrills, MD 21054 | 2019-07-19 |
| 1235699620 | Sara Fiore Schwartz | Nurse Practitioner | 1071 Md-3 Suite 101, Gambrills, MD 21054 | 2019-03-21 |
| 1447759246 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 2401 Brandermill Boulevard Suite 350, Gambrills, MD 21054 | 2018-02-07 |
| 1821546391 | Aamg Physical Therapy, LLC | Speech-Language Pathologist | 1153 Route 3 N, Suite 35, Gambrills, MD 21054 | 2016-09-14 |
| 1780039818 | Drs Ergent Care, LLC | Clinic/Center | 1071 Route 3 N, Gambrills, MD 21054 | 2016-04-26 |
| 1871851212 | Sarsha Blackman | Dentist | 1166 Route 3 South, Suite 211, Gambrills, MD 21054 | 2012-04-23 |
| 1134485535 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 1402 S. Main Chapel Way, Suite 114, Gambrills, MD 21054 | 2012-04-10 |
| Find all providers in zip 21054 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778061 | Kellie Young | Pharmacy Technician | 9004 Townsend Ln, Clinton, MD 20735-2870 | 2020-10-16 |
| 1881211241 | Jennifer Anne Suminski | Pharmacy Technician | 18759 Diller Dr, Hagerstown, MD 21742-2434 | 2020-07-01 |
| 1255962882 | Marjan Hosseinnia | Pharmacy Technician | 25 Dunvale Rd Apt 225, Towson, MD 21204-2527 | 2020-02-02 |
| 1952874406 | Shauntae Turner | Pharmacy Technician | 315 Dark Star Way, Glen Burnie, MD 21060-7442 | 2019-01-08 |
| 1194205153 | Khadijah Keita | Pharmacy Technician | 1512 Woodwell Rd, Silver Spring, MD 20906 | 2018-08-20 |
| 1922504083 | Hoangnam Kim Tran | Pharmacy Technician | 6525 Belcrest Rd Ste 207, Hyattsville, MD 20782-2062 | 2018-04-05 |
| 1992200588 | Brian Ennis | Pharmacy Technician | 2811 Gresham Way Unit 102, Baltimore, MD 21244-3921 | 2018-03-27 |
| 1023566965 | Amanda Arbour | Pharmacy Technician | 111 Sturgill Dr, Bel Air, MD 21015-6111 | 2016-09-21 |
| 1689026361 | Myshaurna Harrison | Pharmacy Technician | 48 Solar Cir Apt L, Parkville, MD 21234-6832 | 2016-07-06 |
| 1881050722 | Jessica Mccorkle | Pharmacy Technician | 3600 Boston St, Baltimore, MD 21224-5729 | 2016-01-07 |
| Find all providers with the same taxonomy | ||||
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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.