Provider Demographics
NPI:1205550407
Name:SCHOFIELD, TRACY LEIGH (PMHNP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LEIGH
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LEIGH
Other - Last Name:PACILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1748 HERITAGE CENTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9855
Mailing Address - Country:US
Mailing Address - Phone:919-529-5920
Mailing Address - Fax:
Practice Address - Street 1:1748 HERITAGE CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9855
Practice Address - Country:US
Practice Address - Phone:919-529-5920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC214675163WP0808X
NC5017240363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health