Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1013156629 |
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| LBN Legal business name | TRINITY MEDICAL CLINIC, LLC | ||||||||
| Authorized official | RHONDA HUNT - (OWNER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 02/05/2009 | ||||||||
| Last updated | 06/19/2024 - More than a year ago | ||||||||
| Identifiers |
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