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General NPI Number Information
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NPI Number | 1346264561
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Entity Type | Individual
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Provider Name | TRACEY A. HAAS D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 2710 HARNEY ST STE 202
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City | LARAMIE
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State | WY
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Zip | 82072-2899
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Country | US
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Telephone | 307-766-3313
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 HARNEY ST STE 202
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City | LARAMIE
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State | WY
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Zip | 82072-2899
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Country | US
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Telephone | 307-766-3313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0056096
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M0100
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12820A
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License Number State | WY
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