Individual
TRACY LYNN WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
8081 INNOVATION PARK DR, FAIRFAX, VA 22031-4867
(571) 472-4724
(571) 472-0241
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-10948
NC
363A00000X
Physician Assistant
Primary
0110009103
VA
363AM0700X
Medical Physician Assistant
PA60188446
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042529
—
OR
05
—
2010598
—
WA
Enumeration date
12/07/2010
Last updated
03/06/2023
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