Provider Demographics
NPI:1396833661
Name:COLLINS, TRACY TAUNEALL (APN)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:TAUNEALL
Last Name:COLLINS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MISS
Other - First Name:TRACY
Other - Middle Name:TAUNEALL
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4445 WHISPERING BEND DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3234
Mailing Address - Country:US
Mailing Address - Phone:901-752-1420
Mailing Address - Fax:
Practice Address - Street 1:4445 WHISPERING BEND DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3234
Practice Address - Country:US
Practice Address - Phone:901-752-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily