Provider Demographics
NPI:1538057849
Name:TRACZ, KENDRA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:TRACZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6709 COUNTY ROAD 25
Mailing Address - Street 2:
Mailing Address - City:ARCHBOLD
Mailing Address - State:OH
Mailing Address - Zip Code:43502-9371
Mailing Address - Country:US
Mailing Address - Phone:419-551-4247
Mailing Address - Fax:
Practice Address - Street 1:6709 COUNTY ROAD 25
Practice Address - Street 2:
Practice Address - City:ARCHBOLD
Practice Address - State:OH
Practice Address - Zip Code:43502-9371
Practice Address - Country:US
Practice Address - Phone:419-551-4247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant