IndividualActive
Abigail Tracy, PA-C
NPI 1336724590 · Physician Assistant · White Bear Lake, MN
Provider details
- NPI number
- 1336724590
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Student, Health Care
Practice location
4480 Centerville Rd
White Bear Lake, MN 55127
Phone: (651) 484-2724
Fax: (651) 484-2723
Approximate (ZIP-level) locationGet directions
Mailing address
4480 Centerville Rd
White Bear Lake, MN 55127
Registry dates
- Enumerated
- 2021-03-09
- Last updated
- 2024-01-19
- Certified
- 2021-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.