SearchIdaho175T00000X

Tracie Hansen, B.S

NPI 1639779523 · on the registry since 2020 · sole proprietor

Practice

Address
560 Fairway Dr
Pocatello, ID 83201
Phone
(208) 242-6669

Registry record

Primary taxonomy
175T00000X
175T00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-10-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho