Jeter, Tracey Mechelle

Jeter, Tracey Mechelle is an individual health care provider with primary practice located at 7010 N 55Th St Apt. G, Milwaukee WI 53223-6349. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Jeter, Tracey Mechelle can be contacted via phone (414) 760-0817.

Contact Information

Primary practice address
7010 N 55Th St Apt. G Milwaukee WI 53223-6349
Phone: (414) 760-0817
Fax: (414) 760-0835
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X Wisconsin

Profile Details

NPI number 1629047055
LBN Legal business name Jeter, Tracey Mechelle
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629047055 NPPES
Wisconsin MEDICAID 39926000

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