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Individual

TRACIE FAWN PFEIFLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN-C

Contact information

Practice address
811 WHITE AVE, GRAND ISLAND, NE 68803-4448
(402) 890-0153
Mailing address
811 WHITE AVE, GRAND ISLAND, NE 68803-4448
(402) 890-0153

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
16114
NE
164W00000X
Licensed Practical Nurse
697
NE

Other

Enumeration date
08/29/2007
Last updated
08/29/2007
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