Provider Demographics
NPI:1073940896
Name:TEXTER, TRACY (NP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:
Last Name:TEXTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 N. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:ST. IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781
Mailing Address - Country:US
Mailing Address - Phone:906-643-0466
Mailing Address - Fax:269-948-3117
Practice Address - Street 1:1140 N. STATE STREET
Practice Address - Street 2:
Practice Address - City:ST. IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781
Practice Address - Country:US
Practice Address - Phone:906-643-0466
Practice Address - Fax:269-948-3117
Is Sole Proprietor?:No
Enumeration Date:2013-10-11
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704230316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily