Individual provider · NPI-1

Tracey Gordon Atherton, PNP

Nurse Practitioner, Pediatrics · Charleston, SC

NPI number1669609798
StatusActive
Last updated in NPPESAug 18, 2015

Details

NPI
1669609798
Entity type
Individual (NPI-1)
Name
Tracey Gordon Atherton
Credential
PNP
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2009
Last updated
Aug 18, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics3568SCYes

Practice location

2051 Charlie Hall Blvd
Charleston, SC 29414-5834

Phone 843-573-2535

Mailing address

2051 Charlie Hall Blvd
Charleston, SC 29414-5834

Phone 843-573-2535

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