Individual
LAURA TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8111 DODGE ST STE 263, OMAHA, NE 68114-4118
(402) 354-8163
(402) 354-2416
Mailing address
PO BOX 3755, OMAHA, NE 68103-2797
(402) 354-5451
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2743
NE
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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