Individual
TRACY A'LISA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN146210
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN12294
TN
367500000X
Certified Registered Nurse Anesthetist
RN159439
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911703
—
AL
05
—
169289780A
—
GA
05
—
3638039
—
TN
01
—
4157079
BCBS OF TN
—
05
—
8052755
—
NC
01
—
P00441414
RAILROAD MEDICARE
—
Enumeration date
08/13/2006
Last updated
05/19/2009
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