Basic Information
Provider Information
NPI: 1457310468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOLSINGER
FirstName: TRACEY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 508 FULTON ST
Address2: DURHAM VA MEDICAL CENTER, MAIL STATION 116A
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber: 9194165832
Practice Location
Address1: 508 FULTON ST
Address2: DURHAM VA MEDICAL CENTER, MAIL STATION 116A
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber: 9194165832
Other Information
ProviderEnumerationDate: 03/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0805X9300717NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry

No ID Information.


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