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General NPI Number Information
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NPI Number | 1932051588
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Entity Type | Individual
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Provider Name | TRACY LYNN GORDON RN
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Gender | Female
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | W220N6151 TOWN LINE RD
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City | SUSSEX
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State | WI
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Zip | 53089-3923
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Country | US
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Telephone | 262-246-1973
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Fax | 262-246-1815
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Provider Business Mailing Address
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Address Line | W230N7439 E STONERIDGE CT
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City | SUSSEX
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State | WI
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Zip | 53089-2057
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Country | US
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Telephone |
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 130443-30
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License Number State | WI
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