Individual
TRACY ADELE CASWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1201 RICKER RD, SALEM, IL 62881-4263
(618) 548-3194
Mailing address
5370 CHURCH RD, SALEM, IL 62881-7202
(618) 367-6145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.0201240
IL
363LF0000X
Family Nurse Practitioner
209.020124041.288784
IL
Other
Enumeration date
09/26/2019
Last updated
12/29/2022
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