Basic Information
| Provider Information | |||||||||
| NPI: | 1760859433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRENT | ||||||||
| FirstName: | LANA | ||||||||
| MiddleName: | BETHANIE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN, NP-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPEARS | ||||||||
| OtherFirstName: | LANA | ||||||||
| OtherMiddleName: | BETHANIE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | APRN, NP-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8474 COUNTY ROAD 107 | ||||||||
| Address2: | |||||||||
| City: | PROCTORVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456698433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046344366 | ||||||||
| FaxNumber: | 3406911477 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE B500 | ||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046911787 | ||||||||
| FaxNumber: | 3406918711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2015 | ||||||||
| LastUpdateDate: | 11/22/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 11/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN66887 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.