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Individual

TRACY C WITTREICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.N.M., M.S.N

Contact information

Practice address
675 S MAIN ST, CHESHIRE, CT 06410-3153
(203) 272-1811
Mailing address
675 S MAIN ST, CHESHIRE, CT 06410-3153
(203) 250-2125
(203) 250-2161

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
LNM 000012
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000012
CONNECTICARE
01
0Q2742
HEALTHNET
01
400000012CT01
ANTHEM BLUE CROSS OF CT
01
P2826209
OXFORD WEALTH PLAN
Enumeration date
06/28/2005
Last updated
05/22/2008
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