=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043451990
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRACY M TOWNE APNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2009
-----------------------------------------------------
Last Update Date | 12/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 540 E GRAND AVE
-----------------------------------------------------
City | BELOIT
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53511-6314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-368-8087
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | N2550 PARADISE CT
-----------------------------------------------------
City | MONROE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53566-9432
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-214-9664
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 17595-33
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 131070-030
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------