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Individual

MRS. NIKKI ORCIUCH TRAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3850 PLEASANT HILL RD, DULUTH, GA 30096-4807
(770) 814-8222
(678) 205-5111
Mailing address
3850 PLEASANT HILL RD, DULUTH, GA 30096-4807
(770) 814-8222
(678) 205-5111

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6321
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003152697B
GA
05
003152697C
GA
05
003152697D
GA
Enumeration date
11/15/2011
Last updated
11/13/2015
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