Allen, Tracy L.

Allen, Tracy L. is an individual health care provider with primary practice located at 101 Riverstone Vis Suite 111, Blue Ridge GA 30513-6648. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Allen, Tracy L. can be contacted via phone (706) 946-4200.

Contact Information

Primary practice address
101 Riverstone Vis Suite 111 Blue Ridge GA 30513-6648
Phone: (706) 946-4200
Fax: (706) 946-4243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-440 Maine
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 005894 Georgia

Profile Details

NPI number 1124036520
LBN Legal business name Allen, Tracy L.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jun 21st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124036520 NPPES
Georgia MEDICAID 003100897C

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