Provider Demographics
NPI:1043036437
Name:GRACIA, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:GRACIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 WASHINGTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CENTRAL FALLS
Mailing Address - State:RI
Mailing Address - Zip Code:02863-8214
Mailing Address - Country:US
Mailing Address - Phone:401-332-7088
Mailing Address - Fax:
Practice Address - Street 1:61 WASHINGTON ST APT 3
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-8214
Practice Address - Country:US
Practice Address - Phone:401-332-7088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker