Individual
KRISTIN TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1799 MOUNT MARIAH DR, LAS VEGAS, NV 89106-1501
(702) 383-1961
(702) 319-6147
Mailing address
3325 RESEARCH WAY, CARSON CITY, NV 89706-7913
(775) 888-6610
(775) 888-4904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1552
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770984064
—
NV
Enumeration date
09/06/2014
Last updated
07/15/2015
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