Phoenix Rising Healthcare
NPI 1093284937ActiveOrganization· Nurse Practitioner, Primary Care· Fairmont, WV
Nurse Practitioner, Primary Care in Fairmont, West Virginia, registered in NPPES in November 2018. The authorized official on file is Traci Tannehill, APRN, Managing Member Of Llc.
Overview
| NPI | 1093284937 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 21, 2018 |
| Last updated in NPPES | Oct 15, 2020 |
| Certified by provider | Oct 15, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other primary care nurse practitioners in Fairmont
- 1033947213
- 1639943400
- 1053191684