Traci Vanderloop, LAT
Individual provider Active NPI Athletic Trainer · Appleton, WI
NPI 1851005797 · NPPES record last updated Jan 5, 2023
Key facts
- NPI
- 1851005797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1373-39 (WI)
- Practice address
- 333 Albert Way
Appleton, WI 54915-6426 - Phone
- (920) 422-0961
- NPI assigned
- Jan 5, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1373-39 | WI | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1373-39 | WI | Yes |
Addresses
Primary practice location
333 Albert Way
Appleton, WI 54915-6426
Mailing address
333 Albert Way
Appleton, WI 54915-6426
Other providers in Appleton, WI
- Rose M. Vandenzen
- Kylie J Vander Hyden
- Drew Vander Velden
- Brianna Rae Vander Zanden
- Maria Vanderlinden
- Constance Mary Vandermoss
- Catherine Ann Vanderpas
- Wanda L Vanderwyst
- Tyler L Vanderzanden
- Stephanie Lynn Vandewettering
All providers in Appleton, WI · Athletic Trainer in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.