Individual
MRS. TRACY A BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226-4861
(414) 454-8460
Mailing address
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226-4861
(414) 454-8460
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
183925-30
WI
363L00000X
Nurse Practitioner
Primary
8649-33
WI
Other
Enumeration date
09/11/2018
Last updated
09/03/2022
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