Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN.CNP.0027167 | OH |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0027167 | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN.425310 | OH |
NPI | 1568085488 |
---|---|
Provider Name | Travis Trayer |
First Address | Perrysburg, OH 43551 |
Second Address | Toledo, OH 43606-3895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2020 |
Last Update Date | 28/08/2020 |