Individual
TRACI M PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3610 RICHMOND CIR STE 100, GRAND ISLAND, NE 68803-3910
(308) 398-6400
(308) 398-6408
Mailing address
PO BOX 1725, GRAND ISLAND, NE 68802-1725
(308) 398-6400
(308) 398-6408
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A144741
IA
363LF0000X
Family Nurse Practitioner
Primary
112074
NE
Other
Enumeration date
07/27/2016
Last updated
04/12/2022
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