Provider Demographics
NPI:1114263787
Name:HILL, TRACY RENEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:RENEE
Last Name:HILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10116 W 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5746
Mailing Address - Country:US
Mailing Address - Phone:913-541-0510
Mailing Address - Fax:913-541-1852
Practice Address - Street 1:10116 W 105TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-5746
Practice Address - Country:US
Practice Address - Phone:913-541-0510
Practice Address - Fax:913-541-1852
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-29
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75872-032363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily