Provider Demographics
NPI:1700403821
Name:TRACY, ROBBI M (APNP)
Entity type:Individual
Prefix:
First Name:ROBBI
Middle Name:M
Last Name:TRACY
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N20W22961 WATERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1306
Mailing Address - Country:US
Mailing Address - Phone:262-875-5070
Mailing Address - Fax:866-384-9486
Practice Address - Street 1:N20W22961 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1306
Practice Address - Country:US
Practice Address - Phone:262-875-5070
Practice Address - Fax:866-384-9486
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10109-33363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care