Healthcare Provider Details

I. General information

NPI: 1013183904
Provider Name (Legal Business Name): TRACEY ELIZABETH BEARD HANSEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E BALTIC ST
NAGS HEAD NC
27959-0108
US

IV. Provider business mailing address

101 W AIRSTRIP RD STE 253
KILL DEVIL HILLS NC
27948-8314
US

V. Phone/Fax

Practice location:
  • Phone: 252-216-1117
  • Fax:
Mailing address:
  • Phone: 252-216-1117
  • Fax: 717-613-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2020-01413
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2020-01413
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: