Individual
TRACY J TEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
812 STATE RD, CHERAW, SC 29520-7113
(843) 537-0961
(843) 537-0908
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
(843) 857-0111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20722
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4450
—
SC
01
—
SCA229
MEDICARE
—
Enumeration date
04/30/2007
Last updated
03/19/2024
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