Basic Information
| Provider Information | |||||||||
| NPI: | 1649432949 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TRINITY NP CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 PELRET PKWY | ||||||||
| Address2: | #200 | ||||||||
| City: | BEREA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402745000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2127 TALL TIMBERS CT | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432289638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144966491 | ||||||||
| FaxNumber: | 6142797337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2008 | ||||||||
| LastUpdateDate: | 08/28/2008 | ||||||||
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| AuthorizedOfficialLastName: | BERTHOLD | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6144966491 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1745451 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse |
No ID Information.