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1821379272
TRACY LYNN INGHAM
WACONIA, MN
NPI
1821379272
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Former Name
TRACY LYNN STAMBOLDJIEV
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: MN A0611105)
Enumeration Date
2011-08-30
Last Update Date
2016-11-03
Business Address
Mrs. TRACY LYNN INGHAM NP-C
424 W STATE HIGHWAY 5 LAKEVIEW CLINIC LTD
WACONIA, MN 55387-1723
Phone number: 952-442-4461
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Mailing Address
Mrs. TRACY LYNN INGHAM NP-C
3603 RAINBOW DR
MINNETONKA, MN 55345-1036
Phone number: 651-895-9464
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