Individual
TRENT ELAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1169 NEW MEXICO DR, XENIA, OH 45385-4774
(937) 344-1048
Mailing address
1169 NEW MEXICO DR, XENIA, OH 45385-4774
(937) 344-1048
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
473776
OH
163WM0705X
Medical-Surgical Registered Nurse
Primary
473776
OH
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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