Individual
TRACEY HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3201 1ST ST, EMMETSBURG, IA 50536-2516
(712) 852-5555
(712) 852-5692
Mailing address
621 S ILLINOIS AVE STE 103, MASON CITY, IA 50401-5489
(641) 428-3041
(712) 852-5692
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
—
—
363LF0000X
Family Nurse Practitioner
Primary
R192078-1
MN
Other
Enumeration date
10/13/2009
Last updated
07/30/2020
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