Tracy Lynn Crookston, PA-C
Physician Assistant, Medical in Hartford, CT. Individual provider (NPI-1).
NPI number1295401511
StatusActive
Last updated in NPPESOct 21, 2021
Details
- NPI
- 1295401511
- Entity type
- Individual (NPI-1)
- Name
- Tracy Lynn Crookston
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 17, 2021
- Certification date
- Oct 21, 2021
- Last updated
- Oct 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 005439 | CT | Yes |
Practice location
80 Seymour StreetHartford Hospital Surgery Dept
Hartford, CT 06102-8000
Phone 860-972-5022
Mailing address
80 Seymour StreetHartford Hospital Surgery Dept
Hartford, CT 06102-8000
Phone 860-972-5022
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