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Individual

MRS. TRINA L GREENWALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP-C, PMHNP-BC

Contact information

Practice address
515 N BRADNER AVE, MARION, IN 46952-2449
(765) 664-8000
(877) 731-2066
Mailing address
515 N BRADNER AVE, MARION, IN 46952-2449
(765) 664-8000
(877) 731-2066

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71002182A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71002182A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000799231
ANTHEM
IN
05
200844580
IN
01
9127305
AETNA
IN
Enumeration date
06/29/2006
Last updated
04/16/2014
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