Provider Demographics
NPI:1992065692
Name:HARRISON, TRACY NICOLE HADNOTT (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:NICOLE HADNOTT
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9500 GILMAN DR DEPT 633
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0633
Practice Address - Country:US
Practice Address - Phone:858-822-1481
Practice Address - Fax:310-206-7186
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA130402207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology