Individual
TRACY PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
116 N 6TH ST, MADISON, WI 53704-4935
(608) 622-3555
Mailing address
116 N 6TH ST, MADISON, WI 53704-4935
(608) 622-3555
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
186626-30
WI
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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