Pedigo, Tracy A

Pedigo, Tracy A is an individual health care provider with primary practice located at 22725 Highway 76 E , Clinton SC 29325-7527. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Pedigo, Tracy A can be contacted via phone (864) 833-9100.

Contact Information

Primary practice address
22725 Highway 76 E Clinton SC 29325-7527
Phone: (864) 833-9100
Fax: (864) 833-9297
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 75568 South Carolina

Profile Details

NPI number 1831179118
LBN Legal business name Pedigo, Tracy A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Dec 27th, 2021 - about 4 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 1831179118 NPPES
South Carolina MEDICAID AN1306

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