| Doctor Name: | TRACY RICEWICK |
| NPI Number: | 1013365279 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | AGNP-BC |
| License Number: | APRN93802 |
| Business Practice Address: | 1600 Medical Center Dr Huntington, WV - 257013656 |
| Business Phone Number: | 3045262310 |
| Business Fax Number: | |
| Mailing Address: | 1600 Medical Center Dr, HUNTINGTON |
| State: | WV |
| Postal Code: | 257013656 |
| Phone Number: | 3045262310 |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2016 |
| NPI Last Update Date: | 05/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | APRN93802 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |