Individual
TRACI WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12120 STATE LINE RD # 296, LEAWOOD, KS 66209-1254
(913) 302-7183
(888) 779-3217
Mailing address
17755 S LAVERTY ST, OLATHE, KS 66062-4528
(620) 224-0573
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
102736
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
53-77126-051
KS
Other
Enumeration date
10/21/2015
Last updated
08/26/2025
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