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General NPI Number Information
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NPI Number | 1881858694
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Entity Type | Individual
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Provider Name | TIMOTHY LEE TRAUGOTT ACNP
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Gender | Male
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 15855 19 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-3504
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Country | US
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Telephone | 586-263-2300
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Fax | 313-876-1305
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Provider Business Mailing Address
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Address Line | 1 FORD PL STE 3A
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-874-4806
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Fax | 313-876-1305
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024177398
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | L154631
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP116679
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9826
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704351488
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704351488
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 683774
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP11174
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License Number State | AZ
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Taxonomy #9
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 683774
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License Number State | TX
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