Provider Demographics
NPI:1255665485
Name:TOOLEY, TRINA MICHELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:MICHELLE
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 20TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-2071
Mailing Address - Country:US
Mailing Address - Phone:304-399-4121
Mailing Address - Fax:304-399-4126
Practice Address - Street 1:1115 20TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-2071
Practice Address - Country:US
Practice Address - Phone:304-399-4121
Practice Address - Fax:304-399-4126
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV71371363LF0000X
KY6152P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9358681Medicare PIN
WV1427063098OtherCORPORATION NPI