National Provider Identifier

Tracie Celeste Irvin, LPN

Tracie Celeste Irvin, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 328-2413.

NPI 1073659868Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1073659868
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
January 29, 2007
Last Updated
July 09, 2007

Practice Location

  • 69 Enterprise St
  • Rochester, NY 14619-2050

Phone: (585) 328-2413

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1073659868
Entity Type
Individual
Last Name
Irvin
First Name
Tracie
Middle Name
Celeste
Name Prefix
MS.
Credential
LPN
Mailing Street Address
69 Enterprise St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14619-2050
Mailing Country
US
Mailing Phone
(585) 328-2413
Mailing Fax
(585) 328-2413
Practice Street Address
69 Enterprise St
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14619-2050
Practice Country
US
Practice Phone
(585) 328-2413
Practice Fax
(585) 328-2413
Enumeration Date
January 29, 2007
Last Updated
July 09, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)
Other Identifiers
02291601 (NY)