Healthcare Provider Details

I. General information

NPI: 1043451990
Provider Name (Legal Business Name): TRACY M TOWNE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E GRAND AVE
BELOIT WI
53511-6314
US

IV. Provider business mailing address

N2550 PARADISE CT
MONROE WI
53566-9432
US

V. Phone/Fax

Practice location:
  • Phone: 608-368-8087
  • Fax:
Mailing address:
  • Phone: 608-214-9664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number17595-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number131070-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: