Healthcare Provider Details

I. General information

NPI: 1811716087
Provider Name (Legal Business Name): TRACI DENEAN PATTON NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3318 BELMONT BLVD
NASHVILLE TN
37215-1640
US

IV. Provider business mailing address

3318 BELMONT BLVD
NASHVILLE TN
37215-1640
US

V. Phone/Fax

Practice location:
  • Phone: 615-400-1363
  • Fax:
Mailing address:
  • Phone: 615-400-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3874040
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: