Individual
IVEYLEE B TRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1622 WESTGATE CIR, BRENTWOOD, TN 37027-8019
(629) 255-2078
(629) 255-4111
Mailing address
222 22ND AVE N, NASHVILLE, TN 37203-1852
(629) 255-3486
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1894
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1526723
—
TN
Enumeration date
11/15/2010
Last updated
02/21/2019
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