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Individual

KELLIE DEANNE TATRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C, RRA, RT(R)

Contact information

Practice address
4800 S CROATAN HWY, NAGS HEAD, NC 27959-9704
(252) 449-5600
Mailing address
4800 S CROATAN HWY, NAGS HEAD, NC 27959-9704
(252) 449-5600

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
349813
363A00000X
Physician Assistant
Primary
301411
NC
363A00000X
Physician Assistant
C0010339
MD

Other

Enumeration date
04/11/2019
Last updated
04/09/2026
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