Individual
TRACY THOMAS SHREVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1530 DRAYTON ROAD, SPARTANBURG, SC 29307
(864) 560-8777
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19945
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4503
—
SC
01
—
SCA1635019
MEDICARE PIN
SC
Enumeration date
01/11/2016
Last updated
04/27/2020
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