Thornsbury, Traci

Thornsbury, Traci is an sole proprietor health care provider with primary practice located at 104 Logan St Ste A , Williamson WV 25661-3606. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Thornsbury, Traci can be contacted via phone (304) 236-5902.

Contact Information

Primary practice address
104 Logan St Ste A Williamson WV 25661-3606
Phone: (304) 236-5902
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 92307 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 92307 West Virginia

Profile Details

NPI number 1407209299
LBN Legal business name Thornsbury, Traci
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2016
Last updated Jan 3rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407209299 NPPES
Kentucky MEDICAID 7100443080

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