Individual
TRACIE DOBYNS LUMPKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11601 IRON BRIDGE RD STE 117, CHESTER, VA 23831-1467
(804) 717-5300
(804) 748-7269
Mailing address
PO BOX 639993, CINCINNATI, OH 45263-9993
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001792
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06249
GROUP PTAN
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
12/07/2005
Last updated
05/17/2023
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