Organization Name: | TRINITY MEDICAL CLINIC, LLC |
NPI Number: | 1013156629 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA L HUNT (CO-OWNER) |
Mailing Address: | 181 South Y Selmer |
State: | TN US |
Postal Code: | 38375 |
Phone Number: | 7314340200 |
Fax Number: | 7314340203 |
NPI Enumeration Date: | 02/05/2009 |
NPI Last Update Date: | 02/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | APN0000007669 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |