TRACEY MARIE SHIVOK-JEFFERSON (NPI# 1053699025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053699025 |
| Entity Type | Individual |
| Full Name | TRACEY MARIE SHIVOK-JEFFERSON |
| Credential | NP-C |
| Practice Address |
2125 Fairview Ave Easton PA 18042-3813 |
| Mailing Address |
3195 Glendon Rd Bethlehem PA 18017-1713 |
| Practice Telephone | 6104190123 |
| Mailing Telephone | 6104190123 |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2014-07-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
SP011299 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2125 FAIRVIEW AVE |
| City | EASTON |
| State | PA |
| Zip Code | 18042-3813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912933466 | Hqm of Easton, LLC | Skilled Nursing Facility | 2125 Fairview Ave, Easton, PA 18042-3813 | 2006-06-25 |
| 1194064683 | New Eastwood Operator Lp | Skilled Nursing Facility | 2125 Fairview Ave, Easton, PA 18042-3813 | 2013-02-04 |
| 1023209301 | Lp Easton LLC | Skilled Nursing Facility | 2125 Fairview Ave, Easton, PA 18042-3813 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570613 | St. Luke's Physician Group, Inc. | Family Medicine | 352 Northampton St, Easton, PA 18042 | 2019-04-18 |
| 1992263909 | St. Luke's Physician Group, Inc. | Internal Medicine | 1905 Hay Terrace, Easton, PA 18042 | 2019-03-08 |
| 1447770342 | Kimberly Vosbury | Occupational Therapy Assistant | 1926 Fairview Avenue, Easton, PA 18042 | 2017-06-21 |
| 1376082610 | Renew Wellness and Psychotherapy | Social Worker | 133 N 4th Street, Easton, PA 18042 | 2017-02-20 |
| 1275078180 | Felicia Moore | Counselor | 1733 Washington Blvd Ste 108, Easton, PA 18042 | 2017-01-01 |
| 1124563127 | Tara Marie George | Counselor | 1101 Northampton St #201, Pinebrook Family Answers, Easton, PA 18042 | 2016-12-29 |
| 1619325446 | Vinay V Bajaj | Surgery | 250 S. 21st Street, Easton Hospital, Easton, PA 18042 | 2016-06-02 |
| 1457709941 | Matthew Bayly | Specialist/Technologist | 750 West Pierce Street, 132 Kirby Sports Center, Easton, PA 18042 | 2016-05-25 |
| 1063881753 | Mackenzie Sara Hubert | Chiropractor | 524 Northampton St, Easton, PA 18042 | 2015-09-23 |
| 1265838932 | Trisha Gill | Nurse Practitioner | 1536 Northampton St, Easton, PA 18042 | 2014-11-07 |
| Find all providers in zip 18042 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356809891 | Jesse Frances Gehman | Nurse Practitioner | 3465 Nazareth Rd Ste 102, Easton, PA 18045-8359 | 2019-03-04 |
| 1740784180 | Melissa Lynn Eigenbrode | Nurse Practitioner | 511 Idlewild Ave Ste B, Easton, MD 21601-3888 | 2018-03-21 |
| 1467974246 | Michelle L Dennis | Nurse Practitioner | 5 Martin Ct, Easton, MD 21601-3833 | 2017-07-12 |
| 1689041733 | Amy Joelle Hoetzel | Nurse Practitioner | 607 Dutchmans Ln, Easton, MD 21601-3345 | 2015-08-25 |
| 1265838932 | Trisha Gill | Nurse Practitioner | 1536 Northampton St, Easton, PA 18042 | 2014-11-07 |
| 1568889095 | Julie Cohen | Nurse Practitioner | 1101 Northampton St, Easton, PA 18042-4152 | 2014-03-21 |
| 1013348473 | Village Health Care LLC | Nurse Practitioner | 373 Houlton Rd, Easton, ME 04740-4337 | 2013-12-10 |
| 1063842359 | Kathryn Heinz | Nurse Practitioner | 3701 Corriere Rd Fl 2, Easton, PA 18045-7991 | 2013-11-22 |
| 1043598444 | Lisette Vazquez | Nurse Practitioner | 8837 Roundhouse Cir, Easton, MD 21601-7903 | 2011-08-02 |
| 1730318320 | Angela R. Buck | Nurse Practitioner | 80 Center Rd, Easton, ME 04740-4337 | 2009-07-06 |
| Find all providers in EASTON | ||||
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| 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.