Tracie Kathryn Myers, TM
Individual provider Active NPI Midwife · Brook Park, MN
NPI 1750687208 · NPPES record last updated Apr 20, 2011
Key facts
- NPI
- 1750687208
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- Practice address
- 22976 Quamba St
Brook Park, MN 55007-4674 - Phone
- (763) 691-3746
- Fax
- (320) 679-7045
- NPI assigned
- Feb 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | Yes |
Addresses
Primary practice location
22976 Quamba St
Brook Park, MN 55007-4674
Mailing address
22976 Quamba St
Brook Park, MN 55007-4674
Phone (763) 691-3746
Other providers in Brook Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.