Provider Demographics
NPI:1871740399
Name:YEHLE, TRACY LOGGINS (RPH)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LOGGINS
Last Name:YEHLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8431 GARVEY DR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3267
Mailing Address - Country:US
Mailing Address - Phone:919-534-1385
Mailing Address - Fax:919-534-1386
Practice Address - Street 1:8431 GARVEY DR
Practice Address - Street 2:SUITE 117
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3267
Practice Address - Country:US
Practice Address - Phone:919-534-1385
Practice Address - Fax:919-534-1386
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist