Individual
ELLEN MARIE TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP
Contact information
Practice address
1110 HIGHLANDS PLAZA DRIVE EAST SUITE220, SAINT LOUIS, MO 63110-3927
(314) 448-3791
Mailing address
660 MASON RIDGE CENTER DRIVE STE 300, SAINT LOUIS, MO 63141
(314) 448-3791
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN500006857
DC
363L00000X
Nurse Practitioner
Primary
2024013672
MO
363LF0000X
Family Nurse Practitioner
NP500006857
DC
Other
Enumeration date
05/19/2020
Last updated
09/19/2025
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