Tracy Crenshaw
Individual provider Active NPI Driver · Shelbyville, TN
NPI 1154869394 · NPPES record last updated Mar 21, 2017
Key facts
- NPI
- 1154869394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 086785935 (TN)
- Practice address
- 112 Public SQ E
Shelbyville, TN 37160-3957 - Phone
- (931) 771-6211
- NPI assigned
- Feb 8, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 086785935 | TN | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Be Blessed Transportation SVC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 086785935 | TN | Yes |
Addresses
Primary practice location
112 Public SQ E
Shelbyville, TN 37160-3957
Mailing address
112 Public SQ E
Shelbyville, TN 37160-3957
Phone (931) 771-6211
Other providers in Shelbyville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.