Provider Demographics
NPI:1194518662
Name:PEOPLES, TRACY
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:PEOPLES
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 1:8147 DELMAR BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3735
Mailing Address - Country:US
Mailing Address - Phone:404-369-4432
Mailing Address - Fax:888-201-1926
Practice Address - Street 1:890 W ELLIOT RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5127
Practice Address - Country:US
Practice Address - Phone:480-454-1781
Practice Address - Fax:800-516-1417
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider