Provider Demographics
NPI:1336336106
Name:TRAYLOR, ROBERT RYAN (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:RYAN
Last Name:TRAYLOR
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2780 AIRPORT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2289
Mailing Address - Country:US
Mailing Address - Phone:614-859-1906
Mailing Address - Fax:614-645-5517
Practice Address - Street 1:777 W STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1523
Practice Address - Country:US
Practice Address - Phone:614-274-1455
Practice Address - Fax:614-274-1433
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2023-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP009855363LF0000X
MI4704309797363LF0000X
OHCOA.09544-NP363LF0000X
OHAPRN.CNP.09544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily