TRACY ROSEBERRY WHNP NPI 1083691489

NPI Information

NPI: 1083691489
Provider Name: TRACY ROSEBERRY, WHNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
5003 HARDY ST
SUITE 350
HATTIESBURG, MS
ZIP 39402
Phone: (601) 268-9393
Get Directions

Tracy Roseberry, WHNP is a women's health nurse practitioner in Hattiesburg, MS. Tracy Roseberry, WHNP NPI is 1083691489. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5003 HARDY ST
SUITE 350
HATTIESBURG, MS
ZIP 39402-319
Phone: (601) 268-9393
Fax: (601) 268-9393

The NPI 1083691489 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 12/27/2005 and was last updated on 10/30/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	R717789	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S39158	MEDICARE UPIN	MISSISSIPPI
2	00118112	MEDICAID	MISSISSIPPI
3	500001254	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI	MS MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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