Dr. Tracy Lynn Ivy, MD
Pediatrics, Pediatric Pulmonology in Saint Louis, MO. Individual provider (NPI-1).
NPI number1710111331
StatusActive
Last updated in NPPESApr 17, 2025
Details
- NPI
- 1710111331
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tracy Lynn Ivy
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 11, 2009
- Last updated
- Apr 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0214X | Pediatrics, Pediatric Pulmonology | 2015008494 | MO | Yes |
| 208000000X | Pediatrics | 2015008494 | MO | |
| 2080S0012X | Pediatrics, Sleep Medicine | 2015008494 | MO |
Practice location
1 Childrens PlDiv Ped Allergy/Immuno/Pulmo
Saint Louis, MO 63110-1002
Phone 314-454-2694 · Fax 314-454-2515
Mailing address
Po Box 7412011Chicago, IL 60674-2011
Phone 314-454-2694 · Fax 314-454-2515
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