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NPI Code Detail

MEDICARE: MRS. TRACY LYNN GORDON RN

MEDICARE: MRS. TRACY LYNN GORDON RN
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
1163WS0200XSchool Registered Nurse130443-30WI

General Provider Information

NPI Number : 1932051588
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY LYNN GORDON RN
Provider Business Mailing Address
First Line : W230N7439 E STONERIDGE CT
Second Line :
City : SUSSEX
State : WI
Zip : 53089-2057
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : W220N6151 TOWN LINE RD
Second Line :
City : SUSSEX
State : WI
Zip : 53089-3923
Country : US
Telephone Number : 262-246-1973
Fax Number : 262-246-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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