| Doctor Name: | MRS. TRACY ANN ROEHL |
| NPI Number: | 1043563463 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN CNP |
| License Number: | R184825-8 |
| Business Practice Address: | 1900 Centracare Cir # 2300 Centracare Clinic Health Plaza Obstetrics And Women's H Saint Cloud, MN - 563035000 |
| Business Phone Number: | 3206543630 |
| Business Fax Number: | 3206543657 |
| Mailing Address: | 1900 Centracare Cir # 2300, Centracare Clinic Health Plaza Obstetrics And Women's H SAINT CLOUD |
| State: | MN |
| Postal Code: | 563035000 |
| Phone Number: | 3206543630 |
| Fax Number: | 3206543657 |
| NPI Enumeration Date: | 10/23/2012 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | R184825-8 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |