Individual ProviderAnnalie TracyNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address187 N Westridge Dr Unit 131, St George, UT 84770-8034(505) 977-1150PECOS EnrollmentBased on the most recent information from CMS, provider Annalie Tracy is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1720722366Provider TypeIndividualFull NameTracy, AnnalieTitleMrs.CredentialNP-CGenderFemaleSole ProprietorNoEnumeration Date4/20/2022Last Updated5/25/2022Contact InformationPractice LocationPractice Address187 N Westridge Dr Unit 131, St George, UT 84770-8034Phone(505) 977-1150FaxUnlisted FaxMailing LocationMailing Address187 N Westridge Dr Unit 131, St George, UT 84770-8034Phone(505) 977-1150FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense108366674405Utah