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General NPI Number Information
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NPI Number | 1629086293
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Entity Type | Individual
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Provider Name | VICKI L TRAXLER PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1660 MEDICAL BLVD STE 100
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City | NAPLES
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State | FL
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Zip | 34110-1415
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Country | US
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Telephone | 239-566-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 MEDICAL BLVD STE 300
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City | NAPLES
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State | FL
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Zip | 34110-1497
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Country | US
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Telephone | 239-513-0053
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Fax | 239-596-0900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | PA1592
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA1592
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License Number State | FL
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