Individual
TRACEY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, SUITE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, SUITE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10316
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10069805
AMERIGROUP
TN
05
—
3628780
—
TN
01
—
4015755
BCBS
TN
01
—
430063250
RAILROAD MEDICARE
TN
01
—
74003161
KY MEDICAID
KY
Enumeration date
06/14/2006
Last updated
11/13/2015
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