Provider Demographics
NPI:1427409481
Name:TRAUGHBER, RACHEL W
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:W
Last Name:TRAUGHBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 OLD JERICHO RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-7731
Mailing Address - Country:US
Mailing Address - Phone:844-852-9510
Mailing Address - Fax:888-241-5699
Practice Address - Street 1:423 FORTRESS BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1351
Practice Address - Country:US
Practice Address - Phone:844-852-9510
Practice Address - Fax:888-241-5699
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010417363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily