| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | Ellingson, Tracy A. · TRACY A. ELLINGSON | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1013957331 | [sources] | |||
| Sector | Ind-Lic HC Serv Prov - Nurse Anesthetist | [sources] | |||
| Status | not available | [sources] | |||
| Address | Charlotte, NC 28204 · MOORESVILLE, NC 28117 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded from South Carolina's Medicaid program.
United States of America · SCDHHS
Service providers who have been terminated for cause from North Carolina's Medicaid and other Health Programs.
United States of America · NC Medicaid Division of Health Benefits
us-medsc-f901f2cafad4e665710c6ec4aad9a7c69dca48f4 · us-mednc-e26bc0827345977dc8dbd3d32d161a538ef381b4For experts: raw data explorer
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| United States | NC Medicaid Division of Health Benefits | - | - |