| Doctor Name: | ALICE R. TRABERT |
| NPI Number: | 1245229558 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | NP-484A |
| Business Practice Address: | 132 5th Ave W Suite 1 Jerome, ID - 833381825 |
| Business Phone Number: | 2088149800 |
| Business Fax Number: | 2088149833 |
| Mailing Address: | Po Box 587, TWIN FALLS |
| State: | ID |
| Postal Code: | 833030587 |
| Phone Number: | 2088147400 |
| Fax Number: | 2088147491 |
| NPI Enumeration Date: | 10/19/2005 |
| NPI Last Update Date: | 01/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | NP-484A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |