Individual
MRS. TRACY MELINDA ARSENAULT
Active
Individual
MRS. TRACY MELINDA ARSENAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085-003952
IL
363AS0400X
Surgical Physician Assistant
Primary
085-003952
IL
363AS0400X
Surgical Physician Assistant
10001255A
IN
363AS0400X
Surgical Physician Assistant
2708-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BLUECROSS BLUESHIELD
IL
Enumeration date
11/17/2010
Last updated
06/26/2014
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