Provider Demographics
NPI:1265120455
Name:GENDRON-TRAINER, NICOLE (CNS-BC, DNP)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:GENDRON-TRAINER
Suffix:
Gender:F
Credentials:CNS-BC, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12112 MAIDENHAIR DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3871
Mailing Address - Country:US
Mailing Address - Phone:571-277-2533
Mailing Address - Fax:
Practice Address - Street 1:12112 MAIDENHAIR DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3871
Practice Address - Country:US
Practice Address - Phone:571-277-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181858364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care