| NPI | 1194949388 |
|---|---|
| Former Name | TRACY ANN BEVERLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105943) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: VA 012000974) |
| 363A00000X Physician Assistant (Licence: VA 0110003365) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9105943) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2019-04-30 |