Healthcare Provider Details

I. General information

NPI: 1477963684
Provider Name (Legal Business Name): TRACEY JEAN SCHLANGEN APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 8TH AVE W
CRESCO IA
52136-1064
US

IV. Provider business mailing address

713 5TH AVE E
CRESCO IA
52136-1321
US

V. Phone/Fax

Practice location:
  • Phone: 563-547-2022
  • Fax: 563-547-4340
Mailing address:
  • Phone: 563-547-3751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5360
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA110364
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: