Individual
TRACY SUZANNE COUSIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1200 6TH AVENUE N, ST CLOUD, MN 56303
(320) 252-5131
(320) 240-2118
Mailing address
1200 6TH AVENUE N, ST CLOUD, MN 56303
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R1602591
MN
Other
Enumeration date
12/13/2005
Last updated
07/08/2007
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