Provider Demographics
NPI:1891109609
Name:TRINITY MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:TRINITY MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEWAYNE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:STEFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:423-239-0099
Mailing Address - Street 1:106 FERRELL AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2655
Mailing Address - Country:US
Mailing Address - Phone:423-239-0099
Mailing Address - Fax:423-239-0273
Practice Address - Street 1:106 FERRELL AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2655
Practice Address - Country:US
Practice Address - Phone:423-239-0099
Practice Address - Fax:423-239-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7390261QP2300X
363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6090229OtherBCBS
TNQ024497Medicaid