Individual
TERRI SUSANN TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1905 W 32ND ST, STE 201, JOPLIN, MO 64804
(417) 206-7900
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
120842
MO
Other
Enumeration date
01/25/2006
Last updated
05/18/2011
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