MRS. TRACEY LYNN MCDONOUGH (NPI# 1902085194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902085194 |
| Entity Type | Individual |
| Full Name | MRS. TRACEY LYNN MCDONOUGH |
| Credential | LPN |
| Practice Address |
150 Richbourg Ave Shalimar FL 32579-1221 |
| Mailing Address |
221 Hospital Dr Ne Fort Walton Beach FL 32548-5066 |
| Practice Telephone | 8508334301 |
| Practice Fax Number | 8508334395 |
| Mailing Telephone | 8508339240 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN5156934 | FL | Nursing Service Providers |
| Street Address |
150 RICHBOURG AVE |
| City | SHALIMAR |
| State | FL |
| Zip Code | 32579-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407382278 | Rehabcare Group East, LLC | Clinic/Center | 1200 Hawthorne Hse Dr, Shalimar, FL 32579 | 2017-05-11 |
| 1952685570 | Gary Anthony Moeller | Dentist | 1 Eleventh Ave, Suite D-3, Shalimar, FL 32579 | 2011-09-30 |
| 1366538035 | Bradley Hamilton Young | Chiropractor | 6 11th Avenue, Suite H-3, Shalimar, FL 32579 | 2006-10-04 |
| 1932111564 | Shalimar Family Dentistry | Dentist | 1 Eleventh Avenue, D-3, Shalimar, FL 32579 | 2006-08-12 |
| 1972761757 | Dr Bradley H Young D C P A | Chiropractor | 6 11th Avenue, Suite H-3, Shalimar, FL 32579 | 2008-05-28 |
| 1528155413 | Howard T Goodpaster | Dentist | 1 Eleventh Avenue, Suite D3, Shclimar, FL 32579 | 2006-10-10 |
| 1912094830 | Lisa E Fletcher | Dentist | 1 Eleventh Avenue, Suite D3, Shclimar, FL 32579 | 2006-10-10 |
| 1255583795 | Ann Mcmanis | Pharmacist | 15 Healthcare Ln, Shalimar, FL 32579-0000 | 2008-10-15 |
| 1699950857 | Karen Michelle Reid | Counselor | 21 Longwood Dr, Shalimar, FL 32579-1013 | 2008-01-07 |
| 1285876540 | Beyond Expectations | Counselor | 21 Longwood Dr, Shalimar, FL 32579-1013 | 2009-04-01 |
| Find all providers in zip 32579 | ||||
| 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 |
|---|---|---|---|---|
| 1558962175 | Talor Meigs | Licensed Practical Nurse | 870 Mande Ct, Shalimar, FL 32579-2303 | 2020-11-02 |
| 1184803223 | Rose Marie Theresa Rakocy | Licensed Practical Nurse | 1350 Joe Martin Cir, Shalimar, FL 32579-1317 | 2007-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871192070 | Layata Shaundria Twitty-kiser | Licensed Practical Nurse | 2521 Spring Forest Road, Tallahassee, FL 32301 | 2020-10-20 |
| 1841898657 | Tamesha L Montgomery | Licensed Practical Nurse | 112 Stock Ave, Interlachen, FL 32148-5095 | 2020-10-14 |
| 1346857299 | Ieshia Nesbitt | Licensed Practical Nurse | 9633 Ne 2nd Dr, Wildwood, FL 34785-8440 | 2020-09-24 |
| 1205443207 | Cheryl Elaine Dowdell | Licensed Practical Nurse | 1685 Biscayne Bay Cir, Jacksonville, FL 32218-8671 | 2020-09-24 |
| 1366057796 | Djuana M Carter | Licensed Practical Nurse | 1837 Lake Chapman Dr Unit 202, Brandon, FL 33510-4169 | 2020-09-11 |
| 1881208130 | Myra Louise Peoples | Licensed Practical Nurse | 4473 Se Village Rd, Stuart, FL 34997-8234 | 2020-09-03 |
| 1417560731 | Melanie Reyes | Licensed Practical Nurse | 968 Allendale Rd, West Palm Beach, FL 33405-1346 | 2020-08-26 |
| 1003429788 | Meline St Pierre | Licensed Practical Nurse | 6607 Willow Street, Zellwood, FL 32798 | 2020-08-24 |
| 1427669134 | Phedia Jean Baptiste | Licensed Practical Nurse | 4709 Nw 9th Dr, Plantation, FL 33317-1482 | 2020-08-14 |
| 1356951933 | Rosemary Solomon | Licensed Practical Nurse | 2207 S Congress Ave Ste A, Palm Springs, FL 33406-7600 | 2020-08-07 |
| 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.