Provider Demographics
NPI:1619345113
Name:MCNAIR, TRACY (NP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:
Last Name:MCNAIR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 VARNARD LN
Mailing Address - Street 2:
Mailing Address - City:CORRYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37721-4426
Mailing Address - Country:US
Mailing Address - Phone:423-736-3272
Mailing Address - Fax:
Practice Address - Street 1:4328 VARNARD LN
Practice Address - Street 2:
Practice Address - City:CORRYTON
Practice Address - State:TN
Practice Address - Zip Code:37721-4426
Practice Address - Country:US
Practice Address - Phone:423-736-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily