Individual
MRS. TRACIE ANN HINAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1122023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42986500
—
WI
01
—
970016614
RAILROAD MEDICARE PROVIDER NUMBER
WI
Enumeration date
07/17/2006
Last updated
05/11/2022
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