Individual
MATHAUS Q TRAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3198
(570) 321-2800
(570) 321-3351
Mailing address
1201 GRAMPIAN BLVD, SUITE 1K, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00543300
NJ
363L00000X
Nurse Practitioner
SP010378
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0749359
CIGNA
—
05
—
1026559160001
—
PA
01
—
2641113
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/03/2009
Last updated
05/02/2016
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