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Individual
TRACY N FOX NELSON
Active
Individual
TRACY N FOX NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9102098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000215800
—
FL
05
—
115029
—
AL
01
—
59193887
BCBS ALABAMA - GBO
AL
01
—
59197534
BCBS ALABAMA
AL
01
—
592-09448
BLUE CROSS BLUE SHIELD
AL
01
—
9147144
AETNA PIN
—
01
—
CL2119
MEDICARE RAILROAD
FL
01
—
P00397348
MEDICARE RAILROAD
FL
01
—
P00869427
MEDICARE RAILROAD
—
01
—
Y01C8
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/22/2006
Last updated
11/29/2011
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