Healthcare Provider Details

I. General information

NPI: 1427363399
Provider Name (Legal Business Name): JENNIFER C TRASKA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER C WASKO

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1299 INDUSTRIAL PKWY N STE 110
BRUNSWICK OH
44212-6366
US

IV. Provider business mailing address

ONE GI CREDENTIALING DEPARTMENT PO BOX 381468
GERMANTOWN TN
38183-1468
US

V. Phone/Fax

Practice location:
  • Phone: 330-225-6468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCOA11687 NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: