Individual
TRACI HARP ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1950 GLENN MITCHELL DR STE 102, VIRGINIA BEACH, VA 23456-0019
(757) 368-0437
Mailing address
6350 CENTER DR, NORFOLK, VA 23502-4107
(757) 905-5558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002964
VA
363A00000X
Physician Assistant
PA08123
TX
Other
Enumeration date
03/20/2009
Last updated
09/15/2025
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