Provider Demographics
NPI:1497865919
Name:TRAYLOR, JAMIE V (CFNP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:V
Last Name:TRAYLOR
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W ROBY DR
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-6113
Mailing Address - Country:US
Mailing Address - Phone:931-289-2450
Mailing Address - Fax:931-289-2453
Practice Address - Street 1:21 W ROBY DR
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-6113
Practice Address - Country:US
Practice Address - Phone:931-289-2450
Practice Address - Fax:931-289-2453
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7798363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4192066OtherINDIVIDUAL BCBS
TN39291991Medicare PIN