St Clair, Traci N

St Clair, Traci N is an individual health care provider with primary practice located at 1229 E Seminole St , Springfield MO 65804-2227. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. St Clair, Traci N can be contacted via phone (417) 820-5610.

Contact Information

Primary practice address
1229 E Seminole St Springfield MO 65804-2227
Phone: (417) 820-5610
Fax: (417) 820-5588
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 2003002310 Missouri

Profile Details

NPI number 1053373696
LBN Legal business name St Clair, Traci N
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Jul 22nd, 2008 - about 18 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 1053373696 NPPES
Missouri Other 2003002310 STATE LICENSE

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