Provider Demographics
NPI:1023414166
Name:CONRAD, TRACY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:
Last Name:CONRAD
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 1:1325 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3786
Mailing Address - Country:US
Mailing Address - Phone:615-212-9915
Mailing Address - Fax:615-794-0041
Practice Address - Street 1:1325 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3786
Practice Address - Country:US
Practice Address - Phone:615-212-9915
Practice Address - Fax:615-794-0041
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist