Provider Demographics
NPI:1699264812
Name:HEARN, TRACY NEWMAN (PT)
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:NEWMAN
Last Name:HEARN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5234
Mailing Address - Country:US
Mailing Address - Phone:615-364-4291
Mailing Address - Fax:
Practice Address - Street 1:1005 GENERATIONS WAY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1580
Practice Address - Country:US
Practice Address - Phone:615-614-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2588225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist