Individual
MS. TRACY A. FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
LUMAR PLAZA, 1847 PSL BLVD, WELLMED MEDICAL MANAGMENT OF FLORIDA, INC., PORT ST. LUCIE, FL 94952
(772) 579-2303
Mailing address
80 GRETA LN, HENDERSON, NC 27537-3475
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NC
Other
Enumeration date
06/28/2006
Last updated
01/23/2008
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