Tracy Lynn Petersen

Case Manager/Care Coordinator · Moline, IL

Individual Active NPI

NPI number 1639785454

Practice location

4600 3rd St
Moline, IL 61265-6106
Phone
(309) 779-3000

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NPI record

NPI
1639785454
Entity type
Individual (Type 1)
Enumeration date
September 17, 2020
Last updated
October 20, 2020
Certified
October 20, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Case Manager/Care Coordinator Primary 171M00000X — —

Mailing address

2200 3rd Ave
Rock Island, IL 61201-8840
Phone
(309) 779-2094

About Tracy Petersen

Tracy Lynn Petersen is a healthcare provider registered in the NPI registry with the primary taxonomy Case Manager/Care Coordinator (code 171M00000X). The practice location is 4600 3rd St, Moline, IL 61265-6106. The NPI number 1639785454 was assigned on September 17, 2020 and the record was last updated on October 20, 2020.

Frequently asked questions

What is the NPI number of Tracy Lynn Petersen?

The NPI number is 1639785454.

What is the phone number of Tracy Petersen?

The phone number listed for the practice location is (309) 779-3000.

Where is Tracy Petersen located?

4600 3rd St, Moline, IL 61265-6106.

What is the taxonomy code for Tracy Petersen?

The primary taxonomy code is 171M00000X – Case Manager/Care Coordinator.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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