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Individual
MS. TRACY CAROLE WATSON
Active
Individual
MS. TRACY CAROLE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSM-CEP, PA-C
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
—
—
363A00000X
Physician Assistant
Primary
0010-01893
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-01893
NC MEDICAL BOARD LICENSE
NC
01
—
580613
AMERICAN COLLEGE OF SPORTS MEDICINE
—
Enumeration date
07/15/2009
Last updated
03/03/2023
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