Basic Information
| Provider Information | |||||||||
| NPI: | 1780286146 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRAVERS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ASHLEY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD, BCOP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 LARUE APT 124 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405178317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7169578403 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 ROSE ST | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405367001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593233997 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2020 | ||||||||
| LastUpdateDate: | 11/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835X0200X | 020663 | KY | Y | Pharmacy Service Providers | Pharmacist | Oncology | 1835P0018X | 020663 | KY | N | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.