Provider Demographics
NPI:1326140500
Name:TRABIN, JANICE (CRNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:TRABIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WALNUT ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1140
Mailing Address - Country:US
Mailing Address - Phone:215-368-1950
Mailing Address - Fax:215-368-9923
Practice Address - Street 1:1000 WALNUT ST
Practice Address - Street 2:SUITE 122
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1140
Practice Address - Country:US
Practice Address - Phone:215-368-1950
Practice Address - Fax:215-368-9923
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP000345B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020018Medicare ID - Type Unspecified