Individual
TARA TRENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
701 N 1ST, SPRINGFIELD, IL 62701
(217) 778-3000
Mailing address
50 VIEW CIR, OREANA, IL 62554-9775
(317) 525-4496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.004940
IL
363A00000X
Physician Assistant
Primary
10001542A
IN
Other
Enumeration date
06/18/2013
Last updated
04/18/2024
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