Healthcare Provider Details

I. General information

NPI: 1184662025
Provider Name (Legal Business Name): TRACY J CURTIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK BLVD
BRISTOL TN
37620-7430
US

IV. Provider business mailing address

6332 OLD JONESBORO RD
BRISTOL TN
37620-3111
US

V. Phone/Fax

Practice location:
  • Phone: 423-844-2600
  • Fax:
Mailing address:
  • Phone: 423-573-4732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9190600
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number14858
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: