Provider Demographics
NPI:1700169240
Name:NOVY, TRAVIS ROBERT (APNP)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:ROBERT
Last Name:NOVY
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1506 S ONEIDA ST
Mailing Address - Street 2:AFFINITY MEDICAL GROUP
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-1305
Mailing Address - Country:US
Mailing Address - Phone:920-730-8700
Mailing Address - Fax:920-730-7691
Practice Address - Street 1:1506 S ONEIDA ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1305
Practice Address - Country:US
Practice Address - Phone:920-730-6700
Practice Address - Fax:920-730-6751
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI4581-033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily