Provider Demographics
NPI:1750972980
Name:ALBERGO, TRACY
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:ALBERGO
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:W154N6180 MARVEL DR
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-5883
Mailing Address - Country:US
Mailing Address - Phone:262-323-1425
Mailing Address - Fax:
Practice Address - Street 1:1000 NORTHVIEW RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-1617
Practice Address - Country:US
Practice Address - Phone:262-548-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-30
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI196248163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health