Provider Demographics
NPI:1528219623
Name:HARSCH, TRACI D (ARNP)
Entity Type:Individual
Prefix:MS
First Name:TRACI
Middle Name:D
Last Name:HARSCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 SW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1633
Mailing Address - Country:US
Mailing Address - Phone:785-368-2000
Mailing Address - Fax:785-368-2098
Practice Address - Street 1:1615 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1633
Practice Address - Country:US
Practice Address - Phone:785-368-2000
Practice Address - Fax:785-368-2098
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS46240OtherSTATE ARNP LICENSE