Provider Demographics
NPI:1972847309
Name:YENNE, TRINA M (APN)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:M
Last Name:YENNE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:1407 MCPHERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-2822
Mailing Address - Country:US
Mailing Address - Phone:618-997-5266
Mailing Address - Fax:618-997-5285
Practice Address - Street 1:3130 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-5951
Practice Address - Country:US
Practice Address - Phone:618-997-5266
Practice Address - Fax:618-997-5285
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2020-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209010025363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health