Neilan, Tracy Raphaela

Neilan, Tracy Raphaela is an individual health care provider with primary practice located at 3495 Iron Horse Rd , Ladson SC 29456-4319. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Neilan, Tracy Raphaela can be contacted via phone (843) 793-5970.

Contact Information

Primary practice address
3495 Iron Horse Rd Ladson SC 29456-4319
Phone: (843) 793-5970
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 17574 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F336742-1 New York

Profile Details

NPI number 1639462591
LBN Legal business name Neilan, Tracy Raphaela
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2011
Last updated Jan 20th, 2022 - about 4 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 1639462591 NPPES
South Carolina MEDICAID NP7662

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