Individual
MS. TRACY DAWN THANGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 747-3581
(314) 747-1710
Mailing address
660 S EUCLID AVE, CB 8054, SAINT LOUIS, MO 63110-1010
(314) 747-3581
(314) 747-1710
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2018044914
MO
Other
Enumeration date
11/15/2018
Last updated
03/07/2019
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