Individual
TRACY LYNNE AMONOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP, CNM
Contact information
Practice address
1750 THOMPSON RD, COOS BAY, OR 97420-2195
(541) 269-0333
(541) 269-7389
Mailing address
1750 THOMPSON RD, COOS BAY, OR 97420-2195
(541) 269-0333
(541) 269-7389
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
202214465NP-PP
OR
176B00000X
Midwife
2023009779
MO
367A00000X
Advanced Practice Midwife
Primary
202214465NP-PP
OR
Other
Enumeration date
03/22/2023
Last updated
10/08/2024
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