MRS. TRACY LYNN INGHAM (NPI# 1821379272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821379272 |
| Entity Type | Individual |
| Full Name | MRS. TRACY LYNN INGHAM |
| Other Name | TRACY LYNN STAMBOLDJIEV |
| Credential | NP-C |
| Practice Address |
424 W State Highway 5 Lakeview Clinic Ltd Waconia MN 55387-1723 |
| Mailing Address |
3603 Rainbow Dr Minnetonka MN 55345-1036 |
| Practice Telephone | 9524424461 |
| Practice Fax Number | 9524421213 |
| Mailing Telephone | 6518959464 |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2016-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A0611105 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
424 W STATE HIGHWAY 5 LAKEVIEW CLINIC LTD |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891725727 | Jaimee Danielle Mcpadden | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2006-07-04 |
| 1518464601 | Alicia Pysick | Nurse Practitioner | 424 W State Highway 5, Waconia, MN 55387-1795 | 2018-04-06 |
| 1427561802 | Ashley Sivanich | Physician Assistant | 424 W State Highway 5, Waconia, MN 55387-1723 | 2017-11-08 |
| 1295180586 | Abigail Krin Elliott | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2016-04-25 |
| 1487037073 | Erin Kathleen Dahn | Registered Nurse | 424 W State Highway 5, Waconia, MN 55387-1723 | 2015-07-01 |
| 1407199110 | David J C Arens | Podiatrist | 424 W State Highway 5, Waconia, MN 55387-1723 | 2013-04-01 |
| 1669608352 | Jennifer Kristin Ische | Family Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-06-08 |
| 1255573416 | Erin Luann Chinnock | Obstetrics & Gynecology | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-04-01 |
| 1134368160 | Tara Lynn Mcmichael | Internal Medicine | 424 W State Highway 5, Waconia, MN 55387-1723 | 2009-02-15 |
| 1609033364 | Lisa Chapman | Obstetrics & Gynecology | 424 W State Highway 5, Waconia, MN 55387-1723 | 2008-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033650627 | Sara Maurer | Nurse Practitioner | 500 S Maple St, Waconia, MN 55387-1752 | 2017-03-15 |
| 1346682473 | Roxy Exner | Nurse Practitioner | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2013-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639731821 | Thomas Bieniek | Nurse Practitioner | 1900 Centracare Cir Ste 1600, Saint Cloud, MN 56303-5000 | 2019-07-08 |
| 1649830225 | Kimberly Dawn Hanson | Nurse Practitioner | 1884 Randolph Ave, Saint Paul, MN 55105-1747 | 2019-06-17 |
| 1942762828 | Jodi Lynn Martin | Nurse Practitioner | 720 Washington Ave Se Ste 300, Minneapolis, MN 55414-2904 | 2019-04-01 |
| 1831661123 | Sheryl Jo Rudolf | Nurse Practitioner | 705 Pleasant Avenue, Park Rapids, MN 56470-1440 | 2018-12-26 |
| 1043730310 | Alexis Oluwasheun Bakare | Nurse Practitioner | 1101 Paul Pkwy Ne Apt 215, Blaine, MN 55434-3977 | 2017-06-27 |
| 1528500360 | Judy Pauletich | Nurse Practitioner | 1255 Mayhill Rd N, Maplewood, MN 55119-7158 | 2016-11-10 |
| 1437506417 | Zahra Roble | Nurse Practitioner | 1801 Nicolllet Ave S, Minneapolis, MN 55403 | 2016-05-19 |
| 1932569035 | David Makonde Ogato | Nurse Practitioner | 5325 W 74th St, Edina, MN 55439-2231 | 2016-03-02 |
| 1164896379 | Brooke Johnson | Nurse Practitioner | 12700 Whitewater Dr, Minnetonka, MN 55343-9438 | 2015-11-25 |
| 1962879916 | Carrie Rose Lucio | Nurse Practitioner | 807 Albert St N, Saint Paul, MN 55104-1302 | 2015-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.