Individual
TRACEY ANN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5215 W 139TH ST, SAVAGE, MN 55378-1954
(650) 556-3321
Mailing address
5215 W 139TH ST, SAVAGE, MN 55378-1954
(650) 556-3321
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
2482415
MN
Other
Enumeration date
12/22/2020
Last updated
12/22/2020
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