Provider Demographics
NPI:1932108644
Name:TRAVER, KAREN S (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:TRAVER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LANDSTUHL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:ATTN: MCEUL-DCCS (CREDENTIALS) CMR 402
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:DE
Mailing Address - Phone:01149637-186-8839
Mailing Address - Fax:01149637-186-6133
Practice Address - Street 1:LANSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:UNIT 21414, BOX 218
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09705
Practice Address - Country:BE
Practice Address - Phone:011326-544-5948
Practice Address - Fax:011326-544-5953
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001331133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2992367Medicare ID - Type Unspecified