Basic Information
| Provider Information | |||||||||
| NPI: | 1225397748 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRENT | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | G | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2199 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370434447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312458400 | ||||||||
| FaxNumber: | 9312458465 | ||||||||
| Practice Location | |||||||||
| Address1: | 2199 MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370434447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312458400 | ||||||||
| FaxNumber: | 9312458465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2012 | ||||||||
| LastUpdateDate: | 05/04/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 89697 | TN | Y | Nursing Service Providers | Registered Nurse |
No ID Information.