Healthcare Provider Details

I. General information

NPI: 1043336456
Provider Name (Legal Business Name): KAREN JULIANO TRAYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BRAXTON CT
FAYETTEVILLE GA
30214-1968
US

IV. Provider business mailing address

217 AMELIA LN
PEACHTREE CITY GA
30269-5607
US

V. Phone/Fax

Practice location:
  • Phone: 770-358-8275
  • Fax:
Mailing address:
  • Phone: 770-632-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN099673
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: