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General NPI Number Information
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NPI Number | 1023466786
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Entity Type | Individual
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Provider Name | TRACY ROMANS NP
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 301 MED TECH PKWY SUITE 240
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2364
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Country | US
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Telephone | 423-794-5888
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Fax | 423-630-5628
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Provider Business Mailing Address
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Address Line | 215 E SPRINGBROOK DR
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City | JOHNSON CITY
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State | TN
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Zip | 37601-1761
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Country | US
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Telephone | 423-794-5738
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Fax | 423-283-9480
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001206813
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21680
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License Number State | TN
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