Individual
MARY A. TRENTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
138 BRIGHTON TER, HOT SPRINGS, AR 71913-7144
(501) 786-8696
Mailing address
106 SECLUDED CIR, LITTLE ROCK, AR 72210-1718
(501) 786-8696
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
A01494
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150741758
—
AR
01
—
500017629
RAILROAD MEDICARE
AR
Enumeration date
10/13/2006
Last updated
11/23/2009
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