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Individual

TRACI MAE HEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
126 MISSOURI AVE, GLWACH (ATTN: SHEILA HAM), FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417
Mailing address
126 MISSOURI AVE, GLWACH (ATTN: SHEILA HAM), FORT LEONARD WOOD, MO 65473-8952
(573) 596-0417

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
110497
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000714
SD

Other

Enumeration date
11/16/2005
Last updated
01/20/2009
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