National Provider Identifier

Tracy L Martine, CRNP

Tracy L Martine, CRNP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 734-7982.

NPI 1770510778Elmira, NYNurse Practitioner

Profile Overview

NPI
1770510778
Provider Type
Individual
Primary Specialty
Nurse Practitioner
Enumeration Date
June 26, 2006
Last Updated
November 25, 2020

Practice Location

  • 1138 Broadway St
  • Elmira, NY 14904-2502

Phone: (607) 734-7982

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Nurse Practitioner (363L00000X)
Full Record
NPI
1770510778
Entity Type
Individual
Last Name
Martine
First Name
Tracy
Middle Name
L
Credential
CRNP
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 873-1244
Practice Street Address
1138 Broadway St
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14904-2502
Practice Country
US
Practice Phone
(607) 734-7982
Practice Fax
(607) 734-1953
Enumeration Date
June 26, 2006
Last Updated
November 25, 2020
Sex
Female
Sole Proprietor
No
Certification Date
November 25, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Nurse Practitioner (363L00000X)
Other Identifiers
102951190 (PA), 05672046 (NY)