Provider Demographics
NPI:1245589191
Name:CURTIS, TRACY ANNA (PA-C)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:ANNA
Last Name:CURTIS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 BROADWAY APT 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-2700
Mailing Address - Country:US
Mailing Address - Phone:720-244-2983
Mailing Address - Fax:
Practice Address - Street 1:10051 LAKE AVE STE 3
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4870
Practice Address - Country:US
Practice Address - Phone:530-587-7461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22509363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant