Provider Demographics
NPI:1013700087
Name:LAUTENSCHLAGER, TRACIE LEE (LPN, WCC)
Entity type:Individual
Prefix:
First Name:TRACIE
Middle Name:LEE
Last Name:LAUTENSCHLAGER
Suffix:
Gender:F
Credentials:LPN, WCC
Other - Prefix:
Other - First Name:TRACIE
Other - Middle Name:LEE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2012
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54903-2012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1302 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-2756
Practice Address - Country:US
Practice Address - Phone:920-279-2814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN820898164W00000X
WI305965164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse