Provider Demographics
NPI:1093722969
Name:LLEWELLYN, TRINA (NP)
Entity Type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:
Last Name:LLEWELLYN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9377 E BELL RD STE 143
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1503
Mailing Address - Country:US
Mailing Address - Phone:602-867-2690
Mailing Address - Fax:602-404-1904
Practice Address - Street 1:9377 E BELL RD STE 143
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1503
Practice Address - Country:US
Practice Address - Phone:602-867-2690
Practice Address - Fax:602-404-1904
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2370363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZRN138371OtherRN
AZ387644Medicaid