Tracy Jacinda Branch, PA
Physician Assistant, Medical in Gaithersburg, MD. Individual provider (NPI-1).
NPI number1003343138
StatusActive
Last updated in NPPESMay 19, 2017
Details
- NPI
- 1003343138
- Entity type
- Individual (NPI-1)
- Name
- Tracy Jacinda Branch
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 19, 2017
- Last updated
- May 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 007573 | NY | Yes |
Practice location
8501 Plum Creek DrGaithersburg, MD 20882-4438
Phone 240-246-7510
Mailing address
5600 Fishers Ln # 16n164cRockville, MD 20852-1750
Phone 301-443-0494
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