MEDICARE: KATIE MARIE TRAVERS PA-C, MSPH

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	363A00000X	Physician Assistant	0010-13584	NC

General Provider Information

NPI Number	:	1336923879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE MARIE TRAVERS PA-C, MSPH

Provider Business Mailing Address
First Line	:	40 MEDICINE CIRCLE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-684-6437
Fax Number	:	919-681-8147

Provider Business Practice Location Address
First Line	:	40 MEDICINE CIRCLE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-0001
Country	:	US
Telephone Number	:	919-684-6437
Fax Number	:	919-681-8147

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

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	02/16/2026

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