Provider Demographics
NPI:1730720996
Name:DRISKILL, TRACEEN EILEEN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:TRACEEN
Middle Name:EILEEN
Last Name:DRISKILL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78295-1346
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 E SONTERRA BLVD STE 170
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4022
Practice Address - Country:US
Practice Address - Phone:210-481-2800
Practice Address - Fax:210-481-2834
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP14399363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner