Tracie Herrell, FNP

Individual provider Active NPI Family Nurse Practitioner · Harrogate, TN

NPI 1295281145 · NPPES record last updated Aug 31, 2016

Key facts

NPI
1295281145
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
21080 (TN)
Practice address
159 Piccadilly Ave
Harrogate, TN 37752
Phone
(865) 368-8602
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
21080TNMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21080 TN Yes

Addresses

Primary practice location

159 Piccadilly Ave
Harrogate, TN 37752

Mailing address

PO Box 501
Kodak, TN 37764-0501
Phone (865) 368-8602

Other providers in Harrogate, TN

All providers in Harrogate, TN · Family Nurse Practitioner in Tennessee

Sources for this page

Verify at the official NPI Registry.