Provider Demographics
NPI:1639493380
Name:CARTER, TRACY L (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 VIRGINIA WAY
Mailing Address - Street 2:STE 390
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-9505
Mailing Address - Country:US
Mailing Address - Phone:615-223-1351
Mailing Address - Fax:615-223-1351
Practice Address - Street 1:515 STONECREST PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6826
Practice Address - Country:US
Practice Address - Phone:615-223-1350
Practice Address - Fax:615-223-1351
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily