Individual
TRACY L INGERSOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-3830
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-3830
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
039791-23
NH
363L00000X
Nurse Practitioner
101.0134980
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039791-21
NURSING LICENSE
NH
Enumeration date
09/18/2021
Last updated
10/04/2021
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