Individual
TRACY L PROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
715 S 8TH ST, MINNEAPOLIS, MN 55404-1210
(612) 878-6963
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
40331
MN
207V00000X
Obstetrics & Gynecology Physician
40331
MN
207VM0101X
Maternal & Fetal Medicine Physician
Primary
40331
MN
Other
Enumeration date
10/24/2006
Last updated
04/19/2022
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