Individual
KAREN LEE TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5725
(573) 332-0808
(573) 339-7945
Mailing address
408 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5725
(573) 332-0808
(573) 339-7945
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN147998
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010626
GROUP PTAN
MO
01
—
1609095975
SITE NPI
MO
05
—
425050556
—
MS
01
—
835650626
PTAN
MO
Enumeration date
08/12/2006
Last updated
07/21/2022
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