Provider Demographics
NPI:1881023000
Name:TRAUTWEIN, COLLEEN (NP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:TRAUTWEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:CAHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1 SEAGATE # 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:567-585-1964
Mailing Address - Fax:
Practice Address - Street 1:2120 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3834
Practice Address - Country:US
Practice Address - Phone:419-824-1785
Practice Address - Fax:419-824-5953
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN312602163W00000X
OH15237363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094483Medicaid
OH0094483Medicaid