Doctor Name: | MRS. RENE L TROTTER |
NPI Number: | 1568446805 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 20900237 |
Business Practice Address: | 104 E Market St Mc Leansboro, IL - 628591317 |
Business Phone Number: | 6186433051 |
Business Fax Number: | 6186433164 |
Mailing Address: | 104 E Market St, MC LEANSBORO |
State: | IL |
Postal Code: | 628591317 |
Phone Number: | 6186433051 |
Fax Number: | 6186433164 |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 02/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 20900237 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |