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General NPI Number Information
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NPI Number | 1841369899
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Entity Type | Individual
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Provider Name | TRACI LYNN PRAYNER CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | PO BOX 1506
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City | CHEHALIS
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State | WA
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Zip | 98532-0409
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Country | US
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Telephone | 360-242-3010
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Fax | 360-740-1987
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Provider Business Mailing Address
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Address Line | PO BOX 1506
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City | CHEHALIS
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State | WA
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Zip | 98532-0409
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Country | US
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Telephone | 360-242-3008
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Fax | 608-077-6873
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP60134098
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 55608
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | TEMPORARY
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 0001171560
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License Number State | VA
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