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Individual

TRACI L CHILDRESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, PMHNP-BC

Contact information

Practice address
1276 GILBREATH DR, JOHNSON CITY, TN 37614-6503
(423) 439-1000
Mailing address
1167 SPRATLIN PARK DR, GRAY, TN 37615-6205
(423) 467-3600
(423) 467-3644

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
36836
TN

Other

Enumeration date
06/12/2024
Last updated
11/04/2025
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