Tracy Lynn Custer I, is a
Licensed Practical Nurse based in Spencerville, Ohio. Tracy Lynn Custer I is licensed to practice in Ohio (license number 161430) and her current practice location is
105 Primrose Pl, Spencerville, Ohio. She can be reached at her office (for appointments etc.) via phone at
(419) 236-2755.
NPI number for Tracy Lynn Custer I is 1629576624 and her current mailing address is 311 E Market St Fl 3, Lima, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1629576624.
Provider's Profile
| Full Name | Tracy Lynn Custer I |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 105 Primrose Pl, Spencerville, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1629576624
- Provider Enumeration Date: 01/25/2018
- Last Update Date: 01/25/2018
Medical Identifiers
Medical identifiers for Tracy Lynn Custer I such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629576624 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 161430 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tracy Lynn Custer I is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tracy Lynn Custer I,
311 E Market St Fl 3,
Lima, OH 45801-4535
Ph: (419) 222-4474 | Tracy Lynn Custer I,
105 Primrose Pl,
Spencerville, OH 45887-1252
Ph: (419) 236-2755 |
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