Provider Demographics
NPI:1841423233
Name:POOLE, TRACI MICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACI
Middle Name:MICHELLE
Last Name:POOLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 BELMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3758
Mailing Address - Country:US
Mailing Address - Phone:615-460-6040
Mailing Address - Fax:615-460-5980
Practice Address - Street 1:1900 BELMONT BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3758
Practice Address - Country:US
Practice Address - Phone:615-460-6040
Practice Address - Fax:615-460-5980
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209218183500000X
TN35491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist