Individual
TRACY L DYSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
20930 DUPONT BLVD UNIT 202, GEORGETOWN, DE 19947-1724
(302) 202-3438
Mailing address
703 PHILLIPS HILL DR, MILLSBORO, DE 19966-1764
(815) 275-9933
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
041-265219
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L78334
MEDICARE PRIOR 7/15/2007
IL
Enumeration date
02/14/2006
Last updated
07/11/2023
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