Individual
TEENA L TRENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1740 NICHOLASVILLE RD, LEXINGTON, KY 40503-1431
(859) 260-6348
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA523
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000675680
NNIKY - ANTHEM
KY
01
—
0000521554
NNIKY - HUMANA
KY
01
—
118070
NNIKY - SIHO
KY
01
—
50034583
PASSPORT - NNIKY
KY
05
—
95005658
—
KY
Enumeration date
08/31/2007
Last updated
12/04/2020
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