Tracie Blue
Registered Nurse in Greenville, SC. Individual provider (NPI-1).
NPI number1447867205
StatusActive
Last updated in NPPESJun 17, 2021
Details
- NPI
- 1447867205
- Entity type
- Individual (NPI-1)
- Name
- Tracie Blue
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2020
- Certification date
- Jun 17, 2021
- Last updated
- Jun 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 259751 | SC | Yes |
| 164W00000X | Licensed Practical Nurse | 44650 | SC |
Practice location
137 Commons WayGreenville, SC 29611-3850
Phone 864-979-0846
Mailing address
Po Box 26534Greenville, SC 29616-1534
Phone 864-567-8976
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