| Doctor Name: | MARY MADOLYN TRAVER |
| NPI Number: | 1710254610 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | RN216511-COA1 |
| Business Practice Address: | 1100 W Main St Woodville, OH - 434699723 |
| Business Phone Number: | 4198492871 |
| Business Fax Number: | 4198493865 |
| Mailing Address: | 2200 Jefferson Ave, 5th Fl Credentiaing Department TOLEDO |
| State: | OH |
| Postal Code: | 436047101 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2011 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN216511-COA1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |