Healthcare Provider Details

I. General information

NPI: 1093165441
Provider Name (Legal Business Name): MRS. TRACEY LYNN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRACEY LYNN MCFALL NP

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 BRANSON LANDING BLVD STE 408
BRANSON MO
65616-2192
US

IV. Provider business mailing address

525 BRANSON LANDING BLVD
BRANSON MO
65616-2052
US

V. Phone/Fax

Practice location:
  • Phone: 417-348-8313
  • Fax: 417-348-8319
Mailing address:
  • Phone: 417-348-8270
  • Fax: 417-348-8319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2016004486
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number137348
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: