Provider Demographics
NPI:1003128604
Name:TRAYLOR, JANELLE MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:MARIE
Last Name:TRAYLOR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 N STEMMONS FWY
Mailing Address - Street 2:UROLOGY CLINIC, SUITE F4300, MSC F4.04
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2700
Mailing Address - Country:US
Mailing Address - Phone:214-456-2365
Mailing Address - Fax:214-456-8803
Practice Address - Street 1:2350 N STEMMONS FWY
Practice Address - Street 2:F4.04 UROLOGY CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2700
Practice Address - Country:US
Practice Address - Phone:214-456-2483
Practice Address - Fax:214-456-8803
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX707293163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse