Individual
MS. TRACY L DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Mailing address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
53-45638-111
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
45638
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110661011
MEDICARE PTAN
KS
05
—
200439000G
—
KS
Enumeration date
07/12/2006
Last updated
10/24/2016
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