Individual
TRACY HOELTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4951 W 18TH ST, LAWRENCE, KS 66047-2090
(785) 841-6540
(785) 841-3129
Mailing address
1000 CARONDELET DR, PROVIDER ENROLLMENT, KANSAS CITY, KS 66112-1636
(816) 943-5744
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1501842
KS
363AS0400X
Surgical Physician Assistant
1501842
KS
Other
Enumeration date
09/29/2015
Last updated
10/06/2022
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