Provider Demographics
NPI:1477395275
Name:TRIGOSO-THIBODEAU, ADRIANA Z (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:Z
Last Name:TRIGOSO-THIBODEAU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 PEACHTREE INDUSTRIAL BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5034
Mailing Address - Country:US
Mailing Address - Phone:678-585-4959
Mailing Address - Fax:
Practice Address - Street 1:3840 PEACHTREE INDUSTRIAL BLVD STE 250
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5034
Practice Address - Country:US
Practice Address - Phone:678-585-4959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281422207Q00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily