Individual
TRACY KING FASOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
317 SAINT FRANCIS DR, GREENVILLE, SC 29601-3965
(864) 255-1304
Mailing address
PO BOX 25039, GREENVILLE, SC 29616-0039
(864) 605-3720
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F1070
SC
Other
Enumeration date
05/05/2006
Last updated
09/24/2014
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