Provider Demographics
NPI:1114991148
Name:TRAFTON, SUSAN C (PA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:C
Last Name:TRAFTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 911
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302
Mailing Address - Country:US
Mailing Address - Phone:207-396-7600
Mailing Address - Fax:207-396-7986
Practice Address - Street 1:81 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 1300
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-729-1148
Practice Address - Fax:207-729-2789
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA896363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical