Provider Demographics
NPI:1184608754
Name:LAMEY, TRACY R (APRN)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:R
Last Name:LAMEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 HARKRIDER ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5631
Mailing Address - Country:US
Mailing Address - Phone:501-514-8531
Mailing Address - Fax:501-358-6045
Practice Address - Street 1:523 HARKRIDER ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5631
Practice Address - Country:US
Practice Address - Phone:501-514-8531
Practice Address - Fax:501-358-6045
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2023-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA002974363L00000X
ARA02974 ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOQ33802Medicare UPIN