Provider Demographics
NPI:1235974148
Name:TRACY, CHEYENNE BAILEY (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHEYENNE
Middle Name:BAILEY
Last Name:TRACY
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:BAILEY
Other - Last Name:CHUTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79007-7579
Mailing Address - Country:US
Mailing Address - Phone:806-274-5131
Mailing Address - Fax:806-273-7777
Practice Address - Street 1:101 S MCGEE ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4019
Practice Address - Country:US
Practice Address - Phone:806-274-5131
Practice Address - Fax:806-273-7777
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily