Provider Demographics
NPI:1720845860
Name:MARGETSON, TRACY LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:MARGETSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11495 SEASONS PL UNIT 201
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-5650
Mailing Address - Country:US
Mailing Address - Phone:262-995-4348
Mailing Address - Fax:
Practice Address - Street 1:4006 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-4819
Practice Address - Country:US
Practice Address - Phone:262-771-1700
Practice Address - Fax:262-925-3255
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15129-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily