TRACY HEATHER PELLETIER (NPI# 1003823428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003823428 |
| Entity Type | Individual |
| Full Name | TRACY HEATHER PELLETIER |
| Credential | NP |
| Practice Address |
636 Del Prado Blvd S Ste A5510 Cape Coral FL 33990-2668 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393435537 |
| Practice Fax Number | 2393438249 |
| Mailing Telephone | 2393435537 |
| Mailing Fax Number | 2393438249 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP3217402 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 105187100 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 8th St N, Naples, FL 341025519 | 2397757757 | 2397755248 |
| Street Address |
636 DEL PRADO BLVD S STE A5510 |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33990-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114909926 | Celeste M. Correa | Family Medicine | 636 Del Prado Blvd S Ste A5510, Cape Coral, FL 33990 | 2005-11-17 |
| 1245880814 | Frances Haas | Nurse Practitioner | 636 Del Prado Blvd S Ste A5510, Cape Coral, FL 33990-2668 | 2019-09-16 |
| 1790861268 | Dianne P Enright | Nurse Practitioner | 636 Del Prado Blvd S Ste A5510, Cape Coral, FL 33990-2668 | 2006-10-27 |
| 1487622833 | James Daniel Gifford | Internal Medicine | 636 Del Prado Blvd S Ste A5510, Cape Coral, FL 33990-2668 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902462 | Shahida Rafiq | Pharmacist | 1619 Delprado Blvd, Cape Coral, FL 33990 | 2020-11-03 |
| 1386259208 | Hope of Life Medical Supply Corp | Durable Medical Equipment & Medical Supplies | 2328 Hancock Bridge Pkwy 1st Fl Ste 114-e, Cape Coral, FL 33990 | 2020-09-09 |
| 1669001814 | Jamie Lindon Kohl | Specialist/Technologist | 605 Se 13th Ct, Cape Coral, FL 33990 | 2020-04-08 |
| 1548809551 | Medical Risk Solutions | Family Medicine | 1020 Cultural Park Blvd, Cottage #7, Cape Coral, FL 33990 | 2019-12-23 |
| 1013495175 | Sunshine Assisted Living Home Care Facility. | Assisted Living Facility | 1422 Se 23rd Ter., Crape Coral, FL 33990 | 2018-08-01 |
| 1215429279 | Five Star Homecare LLC | Adult Companion | 629 Se 10th Pl, Cape Coral, FL 33990 | 2018-06-05 |
| 1730679192 | Amanda Tiana Bright | Developmental Therapist | 1507 Se 18th St, Cape Coral, FL 33990 | 2018-05-11 |
| 1487170908 | Natalie Diaz | Behavior Technician | 317 Se 16th Place, Cape Coral, FL 33990 | 2017-08-16 |
| 1679097273 | Centro Medico LLC | Clinic/Center | 1425 Viscaya Pkwy Ste 101, Cape Coral, FL 33990 | 2017-07-26 |
| 1629506308 | Besties LLC | Adult Companion | 518 Se 20th Ct, Cape Coral, FL 33990 | 2017-05-25 |
| Find all providers in zip 33990 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395752 | Daynet Vera Ayala | Nurse Practitioner | 38 Ne 29th St, Cape Coral, FL 33909-8856 | 2020-10-29 |
| 1972100766 | Tia Evenson | Nurse Practitioner | 1708 Cape Coral Pkwy W Ste 2, Cape Coral, FL 33914-6985 | 2020-10-05 |
| 1730796947 | Michelle Rentas | Nurse Practitioner | 715 Sw 11th Ct, Cape Coral, FL 33991-2148 | 2020-09-30 |
| 1053928804 | Brett M Wilson | Nurse Practitioner | 2030 Nw 5th Ter, Cape Coral, FL 33993-7536 | 2020-09-25 |
| 1023621091 | Haney Sosa | Nurse Practitioner | 1720 Nw 20th St, Cape Coral, FL 33993-4994 | 2020-08-28 |
| 1083226724 | Joaccy Lazo Reyes | Nurse Practitioner | 2211 Se 15th Ave, Cape Coral, FL 33990-4659 | 2020-08-22 |
| 1538770235 | Bethany Lynn Loppnow | Nurse Practitioner | 5113 Chiquita Blvd S, Cape Coral, FL 33914-6988 | 2020-08-14 |
| 1619587003 | Pamela Fay | Nurse Practitioner | 2458 Blackburn Cir, Cape Coral, FL 33991-3140 | 2020-07-31 |
| 1396362679 | Alain Ramirez Gonzalez | Nurse Practitioner | 211 Nw 4th Pl, Cape Coral, FL 33993-2456 | 2020-07-02 |
| 1356977391 | Osmani Rico Valdes | Nurse Practitioner | 1419 Sw 48th Ter Apt 102, Cape Coral, FL 33914-6975 | 2020-03-22 |
| Find all providers in CAPE CORAL | ||||
| City | CAPE CORAL |
| Zip Code | 33990 |
Please comment or provide details below to improve the information on TRACY HEATHER PELLETIER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.