Individual
LISA TRACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1308 JACKSON ST STE 302, OMAHA, NE 68102-1659
(402) 680-4890
Mailing address
1308 JACKSON ST STE 302, OMAHA, NE 68102-1659
(402) 680-4890
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
32454
NE
Other
Enumeration date
05/14/2024
Last updated
05/14/2024
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