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Individual

TRINA LEANNE ANTONELLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
10160 CAVALRY CIR, RENO, NV 89521-4173
(810) 845-1510
Mailing address
10160 CAVALRY CIR, RENO, NV 89521-4173
(810) 845-1510

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704242412
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA000414
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001421100
FL
01
G003U
BCBS
FL
01
P00772720
RAILROAD MEDICARE
FL
Enumeration date
01/06/2009
Last updated
09/11/2016
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