Provider Demographics
NPI:1871801258
Name:EMERSON, TRACY LYNN (RN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:EMERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3401
Mailing Address - Country:US
Mailing Address - Phone:302-672-1592
Mailing Address - Fax:302-672-1595
Practice Address - Street 1:945 FOREST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3401
Practice Address - Country:US
Practice Address - Phone:302-672-1592
Practice Address - Fax:302-672-1595
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1- 0027184163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse