Provider Demographics
NPI:1073233201
Name:CONWAY, TRENTON (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:TRENTON
Middle Name:
Last Name:CONWAY
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6518 DEVONSHIRE AVE APT A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2647
Mailing Address - Country:US
Mailing Address - Phone:618-571-0032
Mailing Address - Fax:
Practice Address - Street 1:6400 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1997
Practice Address - Country:US
Practice Address - Phone:618-571-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041480155163W00000X
MO2018021776163W00000X
IL209026341363LF0000X
MO2022041567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse