MRS. TRACY WHITE ETHRIDGE (NPI# 1972722668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972722668 |
| Entity Type | Individual |
| Full Name | MRS. TRACY WHITE ETHRIDGE |
| Credential | RN-BC, CNS, LPC |
| Practice Address |
2301 Medpark Dr Rocky Mount NC 27804-2288 |
| Mailing Address |
2000 Perimeter Park Dr Suite 200 Morrisville NC 27560-8442 |
| Practice Telephone | 2529625000 |
| Mailing Telephone | 2529625000 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2016-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
4902 | NC | Behavioral Health & Social Service Providers |
| Y | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
131546 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2301 MEDPARK DR |
| City | ROCKY MOUNT |
| State | NC |
| Zip Code | 27804-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184697716 | Vickie Corbett Ripley | Pharmacist | 2301 Medpark Dr, Coastal Plain Hospital, Rocky Mount, NC 27804-2288 | 2006-02-13 |
| 1558994491 | Candice Sherese Stallworth | Registered Nurse | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2020-02-19 |
| 1609338797 | Nhcs Physicians Inc | Psychiatry & Neurology | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2019-04-05 |
| 1235432485 | Nash Mso, Inc. | Psychiatry & Neurology | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2010-12-09 |
| 1497888960 | James Bell Ward | Counselor | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2007-03-14 |
| 1417905589 | Nash Hospitals Inc | Psychiatric Unit | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2006-05-04 |
| 1487612545 | Carolyn C Mosley | Marriage & Family Therapist | 2301 Medpark Dr, Rocky Mount, NC 27804-2288 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992288419 | Aubrey Kuester | Physical Therapist | Hunter Hills Nursing and Rehab, 7369 Hunter Hill Rd, Rocky Mount, NC 27804 | 2018-09-11 |
| 1134636475 | New Beginning Family Services of Nc | Clinic/Center | 600 Tiffany Blvd Ste H, Rocky Mount, NC 27804 | 2018-01-09 |
| 1033640776 | Simply Frazier Beauty Salon | Specialist | 1141 Jeffreys Rd, Rocky Mount, NC 27804 | 2017-03-24 |
| 1164961942 | Family Care Partners of North Carolina, Pllc | Internal Medicine | 1041 Noel Ln. Ste 105, Rocky Mt., NC 27804 | 2017-02-14 |
| 1164834867 | Ward Specialty Pharmacy LLC | Pharmacy | 3646 Sunset Ave, Suite 110 Barkley Square, Rocky Mount, NC 27804 | 2014-05-29 |
| 1891107678 | Patrick Ignacio | Pharmacist | 3646 Sunset Ave., Suite 110, Rocky Mount, NC 27804 | 2014-05-28 |
| 1023437795 | Down East Hearing | Hearing Aid Equipment | 1356 Benvenue Rd., Rocky Mount, NC 27804 | 2014-04-10 |
| 1659710416 | Sterling House of Rocky Mount | Assisted Living Facility | 650 Goldrock Road, Sterling House of Rocky Mount, Rocky Mount, NC 27804 | 2013-06-14 |
| 1700223609 | Keenya Anderson Staten | Nurse Practitioner | 1701 Sunset Ave Ste 105c, Rocky Mount, NC 27804 | 2013-05-31 |
| 1578844528 | Nathan Thomas Long | Pharmacist | 300 N Grace St Ste 150, Rocky Mount, NC 27804 | 2011-09-05 |
| Find all providers in zip 27804 | ||||
| Taxonomy Code | 364SP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356982797 | Jacqueline Jones Thompson | Clinical Nurse Specialist | 131 Bellfare Dr, Garner, NC 27529-7366 | 2019-10-07 |
| 1467741603 | Martha M Libster | Clinical Nurse Specialist | 4304 W Church St, Farmville, NC 27828-1693 | 2011-03-28 |
| 1578604302 | Gwen E Hampton | Clinical Nurse Specialist | 224 Menius Rd, China Grove, NC 28023-9471 | 2007-02-12 |
| 1407872088 | Ann Louise Robinette | Clinical Nurse Specialist | 12 Hunters Ln, Hendersonville, NC 28791-1663 | 2006-07-15 |
| 1467493981 | Karen Holt Stone | Clinical Nurse Specialist | 321 Court Sq, Ste A, Sanford, NC 27330-5677 | 2006-06-08 |
| 1003888306 | Debra Lynne Minor-schork | Clinical Nurse Specialist | 407 S. Broad St. Ste. 1, Edenton, NC 27932 | 2006-02-02 |
| 1184108201 | Wendy Michelle Lyerly | Clinical Nurse Specialist | 1104a S Main St, Lexington, NC 27292-3134 | 2018-09-25 |
| 1871944975 | Marcia Alvarez | Clinical Nurse Specialist | 1365 Westgate Center Dr, Suite L-1, Winston Salem, NC 27103-2980 | 2016-06-29 |
| 1366890253 | Trina Darlene Powell | Clinical Nurse Specialist | 3713 University Dr, Suite B, Durham, NC 27707-6202 | 2016-06-01 |
| 1134507163 | Lynn Hutchins Psychiatric Nurse | Clinical Nurse Specialist | 4612 Nash St N, Wilson, NC 27896-8725 | 2015-05-11 |
| Find all providers with the same taxonomy | ||||
| City | ROCKY MOUNT |
| Zip Code | 27804 |
Please comment or provide details below to improve the information on MRS. TRACY WHITE ETHRIDGE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.