Provider Demographics
NPI:1902508294
Name:SCHIRM, TRACY ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:ANN
Last Name:SCHIRM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:ANN
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:35 WEDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1212
Mailing Address - Country:US
Mailing Address - Phone:732-796-2294
Mailing Address - Fax:
Practice Address - Street 1:901 ERNSTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-2000
Practice Address - Country:US
Practice Address - Phone:732-654-3165
Practice Address - Fax:732-838-3433
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09568500163WP0809X, 163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult