Basic Information
Provider Information
NPI: 1427058841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAPP
FirstName: TRACY
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 404 WASHINGTON AVE N UNIT 303
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554012903
CountryCode: US
TelephoneNumber: 3204201339
FaxNumber:  
Practice Location
Address1: 1990 CONNECTICUT AVE S
Address2:  
City: SARTELL
State: MN
PostalCode: 563772554
CountryCode: US
TelephoneNumber: 3202575595
FaxNumber: 3202575596
Other Information
ProviderEnumerationDate: 07/28/2005
LastUpdateDate: 01/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X40504MNN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0204X40504MNY Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology

ID Information
IDTypeStateIssuerDescription
HP3857101MNHEALTH PARTNERSOTHER
96525101597201MNPREFERRED ONEOTHER
158835701MNARAZ/ AMERICA'S PPOOTHER
53151820005MN MEDICAID
16-0129201MNMEDICAOTHER
30008200101MNRAILROAD MEDICAREOTHER
41177256201MNGREATWEST HEALTHCAREOTHER
9G488NA01MNBLUE CROSS BLUE SHIELDOTHER
121925C56101MNUCARE OF MINNESOTAOTHER
41177256201MNTRICAREOTHER


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