Individual
TRACI LAYNE TANNEHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
5 ERWIN LN STE A, FAIRMONT, WV 26554-1376
(304) 366-0111
Mailing address
PO BOX 1286, FAIRMONT, WV 26555-1286
(304) 366-0111
(304) 366-2099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73116
WV
Other
Enumeration date
09/27/2013
Last updated
04/05/2022
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