Warren, Tracie

Warren, Tracie is an individual health care provider with primary practice located at 8740 Rivers Ave , North Charleston SC 29406-9211. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Warren, Tracie can be contacted via phone (843) 572-5990.

Contact Information

Primary practice address
8740 Rivers Ave North Charleston SC 29406-9211
Phone: (843) 572-5990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2088 South Carolina

Profile Details

NPI number 1588762835
LBN Legal business name Warren, Tracie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Nov 20th, 2015 - 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 1588762835 NPPES
South Carolina MEDICAID 2137PA

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