Individual
MRS. TRACY SHAREE SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
810 W CHURCH ST, GREENEVILLE, TN 37745-3285
(423) 798-1749
(423) 798-1755
Mailing address
552 JIM FOX RD, GREENEVILLE, TN 37743-4108
(423) 823-0023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000149369
TN
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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