Individual
TRINITY J FUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
836
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279773
MEDICARE ID
NE
Enumeration date
08/23/2006
Last updated
12/10/2007
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