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1124178942

NPI Code Detail

MEDICARE: TRAVIS LEE CHABO CRNA

MEDICARE: TRAVIS LEE CHABO CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	10054	OH
2	163W00000X	Registered Nurse	157760	NC
3	367500000X	Certified Registered Nurse Anesthetist	4542	NC
4	367500000X	Certified Registered Nurse Anesthetist	075309	NC
5	163W00000X	Registered Nurse	340936	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00601250	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1124178942	OTHER	NC	TRICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124178942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS LEE CHABO CRNA

Provider Business Mailing Address
First Line	:	2430 EMERALD PL STE 201
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5743
Country	:	US
Telephone Number	:	252-752-2140
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 EMERALD PL STE 201
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5743
Country	:	US
Telephone Number	:	252-752-2140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	05/26/2026

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Directions to “ TRAVIS LEE CHABO CRNA” Practice Location

Language	Start Address	Practice Location

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