Provider Demographics
NPI:1205321437
Name:HUCK, TRISHA ALISON (LVN)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ALISON
Last Name:HUCK
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 FOSTER CREEK LN APT 1022
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-0891
Mailing Address - Country:US
Mailing Address - Phone:817-679-1478
Mailing Address - Fax:
Practice Address - Street 1:5024 FOSTER CREEK LN APT 1022
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-0891
Practice Address - Country:US
Practice Address - Phone:817-679-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX377534164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse