Roseberry, Tracy

Roseberry, Tracy is an individual health care provider with primary practice located at 5003 Hardy St Suite 350, Hattiesburg MS 39402-1319. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Roseberry, Tracy can be contacted via phone (601) 268-9393.

Contact Information

Primary practice address
5003 Hardy St Suite 350 Hattiesburg MS 39402-1319
Phone: (601) 268-9393
Fax: (601) 268-9393
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X R717789 Mississippi

Profile Details

NPI number 1083691489
LBN Legal business name Roseberry, Tracy
Credentials Women's Health Nurse Practitioner (WHNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Oct 30th, 2015 - about 11 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 1083691489 NPPES
Mississippi MEDICAID 00118112

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