Healthcare Provider Details

I. General information

NPI: 1649489287
Provider Name (Legal Business Name): TRACI NICOLE CUEVAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TACI N COUNLEY MD

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 3RD ST
TOPEKA KS
66606-2438
US

IV. Provider business mailing address

2601 SW 3RD ST
TOPEKA KS
66606-2438
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-5225
  • Fax: 785-270-0005
Mailing address:
  • Phone: 785-354-5225
  • Fax: 785-270-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-33694
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-33694
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: