Provider Demographics
NPI:1710475363
Name:SANCHEZ, TRACY DAWN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:DAWN
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:TRACY
Other - Middle Name:DAWN
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:319 S WILSON ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2943
Mailing Address - Country:US
Mailing Address - Phone:307-577-4832
Mailing Address - Fax:307-577-4841
Practice Address - Street 1:319 S WILSON ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2943
Practice Address - Country:US
Practice Address - Phone:307-577-4832
Practice Address - Fax:307-577-4841
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY49417363LF0000X
COAPN.0993714-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAPN.0993714-NPOtherAPN LICENSE
WYCS04779OtherWYOMING CONTROLLED SUBSTANCE NUMBER
WY49417OtherAPN LICENSE
CORXN.0103185-NPOtherPRESCRIPTIVE AUTHORITY