Provider Demographics
NPI:1184683872
Name:HARDY, TRINESE NICOLE (DRPH, PMHNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:TRINESE
Middle Name:NICOLE
Last Name:HARDY
Suffix:
Gender:F
Credentials:DRPH, PMHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 VISION BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-8808
Mailing Address - Country:US
Mailing Address - Phone:414-324-7942
Mailing Address - Fax:
Practice Address - Street 1:3723 VISION BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8808
Practice Address - Country:US
Practice Address - Phone:414-324-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIB1681445146N00000X
WI144932-030163WC0400X, 163WH0200X
WI6777363LF0000X
FLAPRN9449917363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1184683872Medicaid