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General NPI Number Information
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NPI Number | 1760653372
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Entity Type | Individual
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Provider Name | TINA M TRABER N.P.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2008
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 2581 CLYDE AVE
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City | STATE COLLEGE
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State | PA
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Zip | 16801-7508
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Country | US
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Telephone | 814-943-8164
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Fax | 814-940-7864
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Provider Business Mailing Address
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Address Line | 18914 2ND ST
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City | EAGLE RIVER
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State | AK
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Zip | 99577-8348
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Country | US
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Telephone | 716-982-9905
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Fax | 907-257-7493
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F304807
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 104901
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License Number State | AK
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