Provider Demographics
NPI:1730714148
Name:MAURER, TRACY M (CNP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:M
Last Name:MAURER
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 1:6480 ROCKSIDE WOODS BLVD S STE 330
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2222
Mailing Address - Country:US
Mailing Address - Phone:216-264-2727
Mailing Address - Fax:
Practice Address - Street 1:3743 BOETTLER OAKS DR STE E
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-6227
Practice Address - Country:US
Practice Address - Phone:330-899-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026345363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily