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Individual

TANDALAYA M TRAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4934
(662) 377-2531
(662) 377-2920
Mailing address
5410 MARYLAND WAY STE 300, BRENTWOOD, TN 37027-5339
(615) 371-5744
(888) 241-1404

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R869243
MS
363LF0000X
Family Nurse Practitioner
Primary
R869243
MS

Other

Enumeration date
07/14/2011
Last updated
08/10/2011
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