Provider Demographics
NPI:1790013209
Name:TSCHUDI, TRACY (ARNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:TSCHUDI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1690 ELM ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-3679
Mailing Address - Country:US
Mailing Address - Phone:563-690-2850
Mailing Address - Fax:563-582-5335
Practice Address - Street 1:1690 ELM ST STE 300
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3679
Practice Address - Country:US
Practice Address - Phone:563-690-2850
Practice Address - Fax:563-582-5335
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112249163W00000X
IAG160754363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse