Provider Demographics
NPI:1790293033
Name:NEWMAN, TRACY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:ANN
Other - Last Name:ROBISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7100 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1862
Mailing Address - Country:US
Mailing Address - Phone:913-599-2440
Mailing Address - Fax:913-599-5252
Practice Address - Street 1:10870 BENSON DR STE 2160
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1509
Practice Address - Country:US
Practice Address - Phone:833-357-3227
Practice Address - Fax:913-599-5252
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78032-111363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner