Provider Demographics
NPI:1326833047
Name:DOTSON, TRACI DENISE
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:DENISE
Last Name:DOTSON
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 1:3110 MESA WAY STE C
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4202
Mailing Address - Country:US
Mailing Address - Phone:785-760-3924
Mailing Address - Fax:
Practice Address - Street 1:3110 MESA WAY STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4202
Practice Address - Country:US
Practice Address - Phone:785-760-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty