Provider Demographics
NPI:1063449718
Name:HAYMOND, TRINA RANEE (NP)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:RANEE
Last Name:HAYMOND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:844-735-1418
Mailing Address - Fax:855-737-5542
Practice Address - Street 1:117 E COLORADO BLVD STE 600
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:844-735-1418
Practice Address - Fax:855-737-5542
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP15779363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN556015Medicaid
CAZZZ05454ZMedicare PIN
CAQ70128Medicare UPIN
CARN556015Medicaid