Individual
MS. TRACY R. ENNIS
Active
Individual
MS. TRACY R. ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
PA9108883
FL
363A00000X
Physician Assistant
PA 06798
TX
363A00000X
Physician Assistant
PA9108883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017347700
—
FL
01
—
WYB4U
BCBS
FL
Enumeration date
08/09/2010
Last updated
04/24/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up