MRS. TRACY LYNN VANDER REYDEN (NPI# 1851550115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851550115 |
| Entity Type | Individual |
| Full Name | MRS. TRACY LYNN VANDER REYDEN |
| Other Name | TRACY LYNN LYLES |
| Credential | FNP |
| Practice Address |
2006 S Main St Ste A Goshen IN 46526-5232 |
| Practice Telephone | 5745359100 |
| Mailing Telephone | 5745359100 |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2020-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 71002404A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704267843 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2006 S MAIN ST STE A |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-5232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215435458 | Brittany N Hembree | Surgery | 2006 S Main St Ste A, Goshen, IN 46526-5232 | 2018-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306465331 | Brittaney Lee Torchio | Nurse Practitioner | 5 Coates Dr Ste 2, Goshen, NY 10924-6747 | 2020-04-09 |
| 1184262883 | Guadalupe Smith | Nurse Practitioner | 1007 Harmony Ln, Goshen, KY 40026-9539 | 2019-12-13 |
| 1134761182 | Mariya Dagnese | Nurse Practitioner | 30 Hatfield Lane, St 105, Goshen, NY 10924-6768 | 2019-10-10 |
| 1962930180 | Angela Marie Mattern | Nurse Practitioner | 2012 S Main St Ste C, Goshen, IN 46526-5200 | 2017-06-01 |
| 1720453392 | Joan Susan Wahl | Nurse Practitioner | 6722 State Route 132 Ste A, Goshen, OH 45122-9346 | 2015-12-08 |
| 1164814315 | Siena Lecorps | Nurse Practitioner | 30 Hatfield Ln Ste 208, Goshen, NY 10924-6768 | 2015-02-25 |
| 1801152095 | Jami K Kamp | Nurse Practitioner | 1855 S. Main Street, Suite A, Heart & Vascular Center, Goshen, IN 46526-4723 | 2012-04-02 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1679808919 | Ram Khattri Chettri | Nurse Practitioner | 1855 S Main Street, Suite A, Heart & Vascular Center, Goshen, IN 46526-4723 | 2009-10-05 |
| 1336196591 | Carolin K. Marzouk | Nurse Practitioner | 213 Middlebury Street, Goshen, IN 46528 | 2006-05-31 |
| Find all providers in GOSHEN | ||||
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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.