Individual
TRACY STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2456 N WOODLAWN BLVD STE 5C, WICHITA, KS 67220-3968
(316) 644-4444
Mailing address
9020 W DELANO CIR, WICHITA, KS 67212-4469
(316) 204-3566
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
78591
KS
363LF0000X
Family Nurse Practitioner
AP128436
TX
Other
Enumeration date
07/15/2015
Last updated
01/22/2022
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