Provider Demographics
NPI:1376164533
Name:TRENNER, TAYLOR MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:MARIE
Last Name:TRENNER
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 1:7600 LEESBURG PIKE STE 760E
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2004
Mailing Address - Country:US
Mailing Address - Phone:919-608-2983
Mailing Address - Fax:
Practice Address - Street 1:7600 LEESBURG PIKE STE 760E
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2004
Practice Address - Country:US
Practice Address - Phone:919-608-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001249315163W00000X
VA0024179916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse