Provider Demographics
NPI:1053301069
Name:TRENT, ERIN NICOLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:TRENT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2864 WOODRUFF ST
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28302
Mailing Address - Country:US
Mailing Address - Phone:910-570-3108
Mailing Address - Fax:910-907-4222
Practice Address - Street 1:2864 WOODRUFF ST
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28302
Practice Address - Country:US
Practice Address - Phone:910-570-3108
Practice Address - Fax:910-907-4222
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103722363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC162GGOtherBCBS OF NC
NC13268762OtherPHCS/MULTIPLAN
NC1375522OtherWELLPATH/COVENTRY/DR'S DIRECT
NC4042423OtherCOVENTRY NATIONAL PPO
NCFH4001590OtherFIRST CAROLINA CARE
NC1053301069OtherGEHA
NC3119138OtherUNITED HEALTHCARE
NC1053301069OtherHEALTHNET FEDERAL SERVICES/TRICARE
NC1053301069OtherHEALTHSMART
NC257641OtherMEDCOST LLC
NC4111984OtherCIGNA/GREATWEST
NC9209980OtherAETNA
NC162GGOtherBCBS OF NC