Healthcare Provider Details
I. General information
NPI: 1427058841
Provider Name (Legal Business Name): TRACY E NAPP M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/28/2005
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1990 CONNECTICUT AVE S
SARTELL MN
56377-2554
US
IV. Provider business mailing address
404 WASHINGTON AVE N UNIT 303
MINNEAPOLIS MN
55401-2903
US
V. Phone/Fax
- Phone: 320-257-5595
- Fax: 320-257-5596
- Phone: 320-420-1339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 40504 |
| License Number State | MN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 40504 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: