Tina M Traber, N.P.

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

104901 Issued in AK

Practice address

2581 Clyde Ave
State College, PA 16801-7508

Phone

(814) 943-8164

Fax

(814) 940-7864

NPI assigned

Mar 23, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1760653372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18914 2ND ST",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778348",
            "telephone_number": "716-982-9905",
            "fax_number": "907-257-7493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2581 CLYDE AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017508",
            "telephone_number": "814-943-8164",
            "fax_number": "814-940-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRABER",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-23",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304807",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AK",
            "license": "104901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD NUMBER",
            "identifier": "1760653372",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in State College, PA
• Providers in State College, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.