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NPI Code Detail

MEDICARE: KATHERINE D TRAVNICEK MD

MEDICARE: KATHERINE D TRAVNICEK MD
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
1208100000XPhysical Medicine & Rehabilitation Physician15784NV
2208VP0014XInterventional Pain Medicine Physician15784NV

General Provider Information

NPI Number : 1356467831
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE D TRAVNICEK MD
Provider Business Mailing Address
First Line : 4131 W LOOMIS RD
Second Line : SUITE 300
City : GREENFIELD
State : WI
Zip : 53221-2057
Country : US
Telephone Number : 414-325-7246
Fax Number : 414-325-3770
Provider Business Practice Location Address
First Line : 6064 S FORT APACHE RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5350
Country : US
Telephone Number : 702-940-8007
Fax Number : 702-832-1940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 04/18/2024

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Directions to “ KATHERINE D TRAVNICEK MD” Practice Location

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