MEDICARE: MRS. TRACI L HAY MSN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	CP000485	SD
2	363LF0000X	Family Nurse Practitioner	CP000485	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S114087	OTHER	SD	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831271592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRACI L HAY MSN, CNP

Provider Business Mailing Address
First Line	:	1621 SHERIDAN LAKE RD STE B
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-3432
Country	:	US
Telephone Number	:	605-716-3742
Fax Number	:	605-716-3743

Provider Business Practice Location Address
First Line	:	1621 SHERIDAN LAKE RD STE B
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-3432
Country	:	US
Telephone Number	:	605-716-3742
Fax Number	:	605-716-3743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	11/11/2025

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