Provider Demographics
NPI:1548951114
Name:TRAYNOR, KAESHA CATHERINE
Entity type:Individual
Prefix:
First Name:KAESHA
Middle Name:CATHERINE
Last Name:TRAYNOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAESHA
Other - Middle Name:CATHERINE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5077 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-7868
Mailing Address - Country:US
Mailing Address - Phone:719-238-0501
Mailing Address - Fax:
Practice Address - Street 1:5077 PINE RIDGE DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107-7868
Practice Address - Country:US
Practice Address - Phone:719-238-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant