Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | APN12246 | TN |
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN12246 | TN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN12246 | TN |
NPI | 1134250665 |
---|---|
Provider Name | Tracy C. Baldridge |
First Address | Nashville, TN 37232-8678 |
Second Address | Nashville, TN 37232-5100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 02/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
62-0476822 | TAX ID (01) | TN |
MB1493129 | DEA (01) |