Provider Demographics
NPI:1952675480
Name:DOLBEER, TRACI LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:TRACI
Middle Name:LYNN
Last Name:DOLBEER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TRACI
Other - Middle Name:L
Other - Last Name:DOLBEER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2170 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2927
Mailing Address - Country:US
Mailing Address - Phone:910-295-2100
Mailing Address - Fax:910-235-0619
Practice Address - Street 1:2170 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2927
Practice Address - Country:US
Practice Address - Phone:910-295-2100
Practice Address - Fax:910-235-0619
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09628363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant