Provider Demographics
NPI:1477713105
Name:NATION, TRINA R (RN)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:R
Last Name:NATION
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OBRIEN ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9110
Mailing Address - Country:US
Mailing Address - Phone:307-332-3930
Mailing Address - Fax:
Practice Address - Street 1:29 BLACKCOAL DR
Practice Address - Street 2:
Practice Address - City:FT WASHAKIE
Practice Address - State:WY
Practice Address - Zip Code:85214
Practice Address - Country:US
Practice Address - Phone:307-332-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY9336261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center