Provider Demographics
NPI:1689325011
Name:TRAUM, KIERA (APN)
Entity Type:Individual
Prefix:
First Name:KIERA
Middle Name:
Last Name:TRAUM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KIERA
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:75 E TOMLIN STATION RD
Mailing Address - Street 2:
Mailing Address - City:MICKLETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08056-1430
Mailing Address - Country:US
Mailing Address - Phone:609-502-0370
Mailing Address - Fax:
Practice Address - Street 1:75 E TOMLIN STATION RD
Practice Address - Street 2:
Practice Address - City:MICKLETON
Practice Address - State:NJ
Practice Address - Zip Code:08056-1430
Practice Address - Country:US
Practice Address - Phone:609-502-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01248500363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care