Individual
TRACY MAE PUTTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APNP, AGPCNP-C
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Mailing address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6519-33
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
6519-33
WI
363LG0600X
Gerontology Nurse Practitioner
6519-33
WI
363LP2300X
Primary Care Nurse Practitioner
6519-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194100339
—
WI
Enumeration date
07/29/2015
Last updated
09/18/2015
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