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Organization

SELF WELLNESS & HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY GAFFNEY NURSE PRACTITIONER (OWNER)
(336) 399-7716
Entity
Organization

Contact information

Practice address
4134 MACARTHUR ST, WINSTON SALEM, NC 27107-6124
(336) 399-7716
Mailing address
3601 EBERT CT APT 200C, WINSTON SALEM, NC 27127-5790
(336) 399-7716

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548756547
NPI
NC
Enumeration date
10/01/2021
Last updated
12/16/2025
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