Tracy A Proulx, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10747 Issued in WI

Practice address

4580 S Nicholson Ave
Cudahy, WI 53110-1360

Phone

(414) 326-4800

NPI assigned

Feb 8, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tproulx@ipw-offices.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1457943706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 S NICHOLSON AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531101360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 S NICHOLSON AVE",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531101360",
            "telephone_number": "414-326-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROULX",
        "first_name": "TRACY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tproulx@ipw-offices.org",
            "affiliation": "N",
            "address_1": "4580 S Nicholson Ave",
            "city": "Cudahy",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531101360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joni Penn, RPH
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• Lena G Podolsky, NP
• Ami Prag, MD
• Promise Personal Care LLC
• Pulmonary & Critical Care Associates S C
• Mary Elisabeth Qiblawi, R.D., C.D.
• Rachel Quentin, PHARMD
• Nanak Singh Rai, MD
• Sacha Ramirez, M.D.

• Nurse Practitioner in Cudahy, WI
• Providers in Cudahy, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.