Provider Demographics
NPI:1528318151
Name:FLOYD, TRACEY LYN (CNP)
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:LYN
Last Name:FLOYD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 TURTLE CREEK CIRCLE SUITE F
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558
Mailing Address - Country:US
Mailing Address - Phone:419-825-5151
Mailing Address - Fax:
Practice Address - Street 1:1 TURTLE CREEK CIR
Practice Address - Street 2:SUITE F
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8537
Practice Address - Country:US
Practice Address - Phone:419-825-5151
Practice Address - Fax:419-825-5901
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.13406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0072915Medicaid
OH13406OtherOHIO NP LICENSE
OH0072915Medicaid