Provider Demographics
NPI:1790395150
Name:CVETAN, TRACY LYNN (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:CVETAN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 NW GILLY RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152-1255
Mailing Address - Country:US
Mailing Address - Phone:816-206-0999
Mailing Address - Fax:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5379490042363LF0000X
FLAPRN11008165363LF0000X
MO2020017322363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily