Healthcare Provider Details

I. General information

NPI: 1700441276
Provider Name (Legal Business Name): KRISTEN TRAYNOR ELMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

IV. Provider business mailing address

2021 COPPER LEAF PKWY APT 304
DURHAM NC
27703-7758
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-6216
  • Fax:
Mailing address:
  • Phone: 843-437-7057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number25203
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number024634
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: