Individual
TRACIE MIXON WOODWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
305 W BOBO NEWSOM HIGHWAY, HARTSVILLE, SC 29550
(843) 309-3028
(843) 309-3029
Mailing address
305 W BOBO NEWSOM HIGHWAY, HARTSVILLE, SC 29550
(843) 437-5456
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
18982
SC
363LF0000X
Family Nurse Practitioner
173940
TN
Other
Enumeration date
02/01/2013
Last updated
04/27/2018
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