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NPI Code Detail

MEDICARE: CAROL E TRAVIS CNP

MEDICARE: CAROL E TRAVIS CNP
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
1163WW0101XAmbulatory Women's Health Care Registered NurseRN079550OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1353419OTHEROHWELLCARE
2000000311622OTHEROHANTHEM BC /BS
3500030376OTHEROHRAILROAD CARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144277781
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL E TRAVIS CNP
Provider Business Mailing Address
First Line : 18200 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5605
Country : US
Telephone Number : 216-476-7606
Fax Number : 216-476-6967
Provider Business Practice Location Address
First Line : 18200 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5605
Country : US
Telephone Number : 216-476-7606
Fax Number : 216-476-6967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 06/06/2008

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