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NPI Code Detail

MEDICARE: HEATHER ANN TRAYNHAM NP

MEDICARE: HEATHER ANN TRAYNHAM NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner28559SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SCT0537628OTHERSCMEDICARE PIN

General Provider Information

NPI Number : 1093572752
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER ANN TRAYNHAM NP
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-695-6697
Fax Number :
Provider Business Practice Location Address
First Line : 701 GROVE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4210
Country : US
Telephone Number : 864-455-3287
Fax Number : 864-455-5723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2024
Last Update Date : 06/01/2026

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