Individual
TRACI ANN BAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3922 W MARKET ST, GREENSBORO, NC 27407-1304
(336) 252-3993
(855) 308-2340
Mailing address
PO BOX 360, SYLVA, NC 28779-0360
(888) 339-6065
(828) 538-4441
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011729
NC
363LF0000X
Family Nurse Practitioner
5011729
NC
Other
Enumeration date
05/03/2019
Last updated
08/10/2023
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