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Individual

TRACY A RENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC, ACNS-BC APNP

Contact information

Practice address
246 TIERNEY DR, NEW RICHMOND, WI 54017-2515
(715) 246-2521
(715) 246-7977
Mailing address
893 WILLOW RIVER DR, HUDSON, WI 54016-6944
(715) 246-7895

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2077005215-22
WI
364SA2200X
Adult Health Clinical Nurse Specialist
2006008321-05
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36024100
WI
Enumeration date
12/04/2006
Last updated
09/07/2008
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