Provider Demographics
NPI:1609870625
Name:TRENT, CYNTHIA N (CPNP, AE-C)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:N
Last Name:TRENT
Suffix:
Gender:F
Credentials:CPNP, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 LAKE JAMES DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6779
Mailing Address - Country:US
Mailing Address - Phone:757-523-4589
Mailing Address - Fax:757-523-8920
Practice Address - Street 1:1212 LAKE JAMES DR
Practice Address - Street 2:SUITE C
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6779
Practice Address - Country:US
Practice Address - Phone:757-523-4589
Practice Address - Fax:757-523-8920
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024127248363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7793049Medicaid