NPI 1639779523
Tracie Lyn Hansen, BS
Practice location
- Address
- 560 Fairway Dr, Pocatello, ID 83201-2012
- Phone
- (208) 242-6669
- Mailing address
- 611 Wilson Ave STE 5, Pocatello, ID 83201-5046
Registered specialties
Peer Specialist
Primary
Registry record
- NPI
- 1639779523
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 29 Oct 2020
- Record last updated
- 14 Oct 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.