Healthcare Provider Details

I. General information

NPI: 1720906068
Provider Name (Legal Business Name): MRS. TRACIE LEIGH GASS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 1ST AVE NW
ASHLEY ND
58413-7038
US

IV. Provider business mailing address

224 1ST AVE NW
ASHLEY ND
58413-7038
US

V. Phone/Fax

Practice location:
  • Phone: 717-688-3544
  • Fax:
Mailing address:
  • Phone: 717-688-3544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: