Provider Demographics
NPI:1760444558
Name:PICK, TRACEY ANN (ARNP)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:ANN
Last Name:PICK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105-1436
Mailing Address - Country:US
Mailing Address - Phone:712-252-2477
Mailing Address - Fax:712-252-5920
Practice Address - Street 1:3410 FUTURES DR
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3917
Practice Address - Country:US
Practice Address - Phone:402-412-7242
Practice Address - Fax:712-252-5920
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110545174400000X, 363LF0000X
IAA096027174400000X
SD0302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No174400000XOther Service ProvidersSpecialist