Provider Demographics
NPI:1124214184
Name:HILGERT, TRACY MARIE (RN,BSN,RNFA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:MARIE
Last Name:HILGERT
Suffix:
Gender:F
Credentials:RN,BSN,RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 ALEXANDRIA ROW
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8558
Mailing Address - Country:US
Mailing Address - Phone:618-225-7689
Mailing Address - Fax:618-466-4668
Practice Address - Street 1:2052 ALEXANDRIA ROW
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8558
Practice Address - Country:US
Practice Address - Phone:618-225-7689
Practice Address - Fax:618-466-4668
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119634163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant