TRACY MUMBULO (NPI# 1699130963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699130963 |
| Entity Type | Individual |
| Full Name | TRACY MUMBULO |
| Practice Address |
208 Akutan Ave Unit A Jber AK 99505 |
| Practice Telephone | 9198882291 |
| Mailing Telephone | 9198882291 |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 105653 | AK | Nursing Service Providers |
| Street Address |
208 AKUTAN AVE UNIT A |
| City | JBER |
| State | AK |
| Zip Code | 99505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134763378 | Idris Usman | Social Worker | 786 D St., Jber-richardson, AK 99505 | 2019-10-31 |
| 1114578572 | Matthew Coddington | Physical Therapist | Jber Soldier Centered Medical Home, Building 786, D Street, Jber, AK 99505 | 2019-09-26 |
| 1801362132 | Jolene Danielle Sletten | Audiologist | Soldier Centered Medical Home-u.s. Army, 786 D Street, Joint Base Elemendorf-richardson, AK 99505 | 2018-10-14 |
| 1700322773 | Joshua Hatch | Physician Assistant | Bldg 786 D St., Jber, AK 99505 | 2017-01-13 |
| 1578912598 | Jacob Shook | Family Medicine | Medac 7860, Joint Base Elmendorf Richardson, AK 99505 | 2016-06-09 |
| 1609294933 | Benjamin E. Thompson | Physician Assistant | Jber Scmh, Bldg 786 D St, Jber, AK 99505 | 2014-04-03 |
| 1679990279 | Daniel Lord | Psychologist | 600 Richardson Drive Community Center, Fort Richardson, Anchorage, AK 99505 | 2014-03-21 |
| 1598199028 | Nina Rodriguez | General Practice | 786 D St, Jber, AK 99505 | 2013-09-03 |
| 1720383185 | Nicole Levaillant | Psychologist | Building 786 D Street, Anchorage, AK 99505 | 2011-01-17 |
| 1407160377 | Christopher Hay Caldwell | Optometrist | Jber Scmh, Bldg 786, Optometry, Jber, AK 99505 | 2010-08-03 |
| Find all providers in zip 99505 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457732257 | Yamah Kone | Licensed Practical Nurse | 288 Fishwheel Ave Apt D, Jber, AK 99505-1075 | 2015-06-17 |
| 1770902140 | Alanna Roberts | Licensed Practical Nurse | 6971 Campos Ave Unit D, Jber, AK 99506-3471 | 2014-04-14 |
| 1730510975 | Amber Llewellyn | Licensed Practical Nurse | 6932 Sockeye Ave Unit A, Jber, AK 99506-3576 | 2013-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1336706662 | Cynthia Malina Franco | Licensed Practical Nurse | 670 W Fireweed Ln Ste 106, Anchorage, AK 99503-2562 | 2019-05-22 |
| 1144706458 | Alysia S Peppers | Licensed Practical Nurse | 3628 South Shady Lane, Wasilla, AK 99654 | 2018-07-19 |
| 1083123665 | Mareena Michelle Becerril-wild | Licensed Practical Nurse | 4219 S Pinnacle Peak Dr, Wasilla, AK 99623-0721 | 2017-09-26 |
| 1306364237 | Kenya Renay Hurd | Licensed Practical Nurse | 670 W Fireweed Ln Ste 120, Anchorage, AK 99503-2562 | 2017-08-30 |
| 1154857431 | Emily Nicole Henry | Licensed Practical Nurse | 5500 E 38th Ct Apt 2, Anchorage, AK 99504-4330 | 2017-05-05 |
| 1275068504 | Timothy Shawn Hicks-glover Jr. | Licensed Practical Nurse | 4003 Minnesota Dr Apt 19, Anchorage, AK 99503-6453 | 2017-04-24 |
| 1619408770 | Ashley Long | Licensed Practical Nurse | 3705 Arctic Blvd # 2237, Anchorage, AK 99503-5774 | 2017-03-21 |
| 1508307158 | Eileen Lloyd | Licensed Practical Nurse | 218 Skwentna Dr, Anchorage, AK 99504-4886 | 2017-03-15 |
| 1114467503 | Anna Meisel | Licensed Practical Nurse | 189 E Nelson Ave # 238, Wasilla, AK 99654-6462 | 2017-03-03 |
| Find all providers with the same taxonomy | ||||
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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.