Individual
TRACY L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
3555 SUNSET OFFICE DR STE 107, SAINT LOUIS, MO 63127-1045
(314) 543-5200
(314) 543-5219
Mailing address
PO BOX 419052, SAINT LOUIS, MO 63141-9052
(314) 543-5200
(314) 543-5219
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
2019000944
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2019000944
MO
Other
Enumeration date
01/22/2019
Last updated
08/09/2023
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