Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Traci Nichole Gansberg, FNP

Individual provider Family Nurse Practitioner · NPI 1336692813

Traci Nichole Gansberg, FNP is a Nurse Practitioner in Klamath Falls, Oregon. Qualified in 2016, 10 years ago. Practices with Icco LLC, a 133-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
10
Licensed in
OR
In the registry since
2016
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

2821 Daggett Ave Ste 200
Klamath Falls, OR 97601-1106
Phone: (541) 274-8400
Fax: (541) 274-8405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 201605976NP-PP (OR)

Record details

NPI number1336692813
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 1, 2016
Last updated in NPPESFebruary 11, 2020
Certification dateFebruary 11, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations12 on file with Medicare

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