TRACIE L DAVIS NPI 1639948946

NPI Information

  • NPI: 1639948946
  • Provider Name: TRACIE L DAVIS
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1373 E STATE ROAD 62
    MADISON, IN
    ZIP 47250
  • Phone: (812) 801-0152

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NPI Details

Tracie L Davis is a family nurse practitioner in Madison, IN with 2 years of experience. Tracie L Davis NPI is 1639948946. 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:

1373 E STATE ROAD 62
MADISON, IN
ZIP 47250-328
Phone: (812) 801-0152
Fax: (812) 801-0150

The NPI 1639948946 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/28/2023 and was last updated on 11/6/2025.

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
1363LF0000XNurse PractitionerFamily71014807AINDIANAYes

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
17100963670MEDICAIDKENTUCKY
2300088330MEDICAIDINDIANA

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: 11/21/2025

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