Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 55782 | WI |
NPI | 1740448828 |
---|---|
Provider Name | Dr. Tracy L Capes |
First Address | West Allis, WI 53227-2468 |
Second Address | West Allis, WI 53227-2468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100015702 | (05) | WI |