Provider Demographics
NPI:1205390721
Name:TRAINER, GARRISON R (CNP)
Entity Type:Individual
Prefix:
First Name:GARRISON
Middle Name:R
Last Name:TRAINER
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 GLESSNER AVE
Mailing Address - Street 2:ROOM 325, E. BUILDING
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2269
Mailing Address - Country:US
Mailing Address - Phone:419-520-2495
Mailing Address - Fax:419-520-2496
Practice Address - Street 1:335 GLESSNER AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2269
Practice Address - Country:US
Practice Address - Phone:419-756-5500
Practice Address - Fax:419-756-5502
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024150363LF0000X
OH362502163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse