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Individual
MRS. JUANITA DENAE BRACY
Active
Individual
MRS. JUANITA DENAE BRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPA, ATC, MED.
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
012000864
VA
2255A2300X
Athletic Trainer
—
CA
363A00000X
Physician Assistant
Primary
PA9118228
FL
363AM0700X
Medical Physician Assistant
306479
NC
363AM0700X
Medical Physician Assistant
PA15256
TX
363AM0700X
Medical Physician Assistant
PA60497
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070402592
NATA BOC
CA
01
—
0126000864
ATC VIRGINIA LICENSE
VA
05
—
125670500
—
FL
05
—
PA15256
—
TX
Enumeration date
08/30/2006
Last updated
07/28/2025
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