1295318822 NPI number — MS. CHEYENNE M TRAMMELL PHYSICIAN ASSISTANT

Table of content: MS. CHEYENNE M TRAMMELL PHYSICIAN ASSISTANT (NPI 1295318822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295318822 NPI number — MS. CHEYENNE M TRAMMELL PHYSICIAN ASSISTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRAMMELL
Provider First Name:
CHEYENNE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICIAN ASSISTANT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295318822
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2055 HOSPITAL DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATAVIA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45103-1981
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-735-1701
Provider Business Mailing Address Fax Number:
513-735-8995

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2055 HOSPITAL DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATAVIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45103-1981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-735-1701
Provider Business Practice Location Address Fax Number:
513-735-8995
Provider Enumeration Date:
05/02/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com