Individual
TRACY L PECHACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 735-0501
(651) 735-1870
Mailing address
8681 EAGLE POINT BLVD, LAKE ELMO, MN 55042-8628
(651) 251-8021
(651) 251-8050
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1213470
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066955500
—
MN
Enumeration date
09/16/2006
Last updated
10/05/2010
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