Individual
TRACY M. CREEL
Active
Individual
TRACY M. CREEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA064
MS
363AM0700X
Medical Physician Assistant
PA9103034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001311700
—
FL
05
—
03729301
—
MS
01
—
Y0139
BLUECROSS/BLUESHIELD
FL
Enumeration date
11/18/2005
Last updated
03/21/2011
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