Tracie Louise Channell
Individual provider Active NPI Homemaker · Jackson, OH
NPI 1336064476 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1336064476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- RK078379 (OH)
- Practice address
- 307 McKitterick Ave
Jackson, OH 45640-1025 - Phone
- (740) 988-8823
- NPI assigned
- Aug 10, 2026
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | RK078379 | OH | Yes |
Addresses
Primary practice location
307 McKitterick Ave
Jackson, OH 45640-1025
Mailing address
307 McKitterick Ave
Jackson, OH 45640-1025
Phone (740) 988-8823
Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. 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.