Provider Demographics
NPI:1174624043
Name:NARCELLES, TRECIA LYNN (CNP)
Entity type:Individual
Prefix:
First Name:TRECIA
Middle Name:LYNN
Last Name:NARCELLES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W WARD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2120
Mailing Address - Country:US
Mailing Address - Phone:937-327-7811
Mailing Address - Fax:937-327-7812
Practice Address - Street 1:200 W WARD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2120
Practice Address - Country:US
Practice Address - Phone:937-327-7811
Practice Address - Fax:937-327-7812
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3071821Medicaid
OHH069080Medicare PIN