Individual
TRACY LOCKREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1099 10TH AVE SE, MINNEAPOLIS, MN 55414-1312
(612) 767-6272
Mailing address
1099 10TH AVE SE, MINNEAPOLIS, MN 55414-1312
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1413722
MN
Other
Enumeration date
04/20/2018
Last updated
04/20/2018
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