Individual
MRS. TRACY ANN DERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1238 GADD RD., HIXSON, TN 37343
(423) 875-4806
(423) 874-0094
Mailing address
1238 GADD RD, HIXSON, TN 37343-3917
(423) 875-4806
(423) 874-0094
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0000066774
TN
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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