Blanton, Tracy Elizabeth

Blanton, Tracy Elizabeth is an sole proprietor health care provider with primary practice located at 1007 Lincolnway , La Porte IN 46350-3201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Blanton, Tracy Elizabeth can be contacted via phone (219) 325-5474.

Contact Information

Primary practice address
1007 Lincolnway La Porte IN 46350-3201
Phone: (219) 325-5474
Fax: (219) 325-5456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 28118993A Indiana

Profile Details

NPI number 1508290289
LBN Legal business name Blanton, Tracy Elizabeth
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2013
Last updated Aug 29th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508290289 NPPES
Indiana MEDICAID PENDING

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