Individual
TRACEY QUELLA SPERKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2514 S 102ND ST STE 160, WEST ALLIS, WI 53227-2142
(414) 395-8650
(855) 845-1846
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(484) 346-1692
(855) 618-6655
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
170866
WI
363LF0000X
Family Nurse Practitioner
Primary
13813
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13813
FAMILY NURSE PRACTITIONER LICENSE
WI
Enumeration date
07/02/2021
Last updated
06/23/2023
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