Provider Demographics
NPI:1205075991
Name:DILLON, TRINA MARIE (RN,RAC-T)
Entity type:Individual
Prefix:MS
First Name:TRINA
Middle Name:MARIE
Last Name:DILLON
Suffix:
Gender:F
Credentials:RN,RAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4070 MILLERS LN
Mailing Address - Street 2:
Mailing Address - City:DUNCAN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:43734-9750
Mailing Address - Country:US
Mailing Address - Phone:740-891-1626
Mailing Address - Fax:
Practice Address - Street 1:4070 MILLERS LN
Practice Address - Street 2:
Practice Address - City:DUNCAN FALLS
Practice Address - State:OH
Practice Address - Zip Code:43734-9750
Practice Address - Country:US
Practice Address - Phone:740-891-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN276966163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management