Provider Demographics
NPI:1265099378
Name:STEARNS, TRINA LEIGH-MARIE (LPN)
Entity type:Individual
Prefix:MS
First Name:TRINA
Middle Name:LEIGH-MARIE
Last Name:STEARNS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MOSLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206
Mailing Address - Country:US
Mailing Address - Phone:315-882-4472
Mailing Address - Fax:
Practice Address - Street 1:525 MOSLEY DRIVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206
Practice Address - Country:US
Practice Address - Phone:315-882-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334854-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse