Provider Demographics
NPI:1669903423
Name:NOEL, TRENT DURAND
Entity type:Individual
Prefix:
First Name:TRENT
Middle Name:DURAND
Last Name:NOEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5502 BOUNDS ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-1202
Mailing Address - Country:US
Mailing Address - Phone:540-455-8239
Mailing Address - Fax:
Practice Address - Street 1:5502 BOUNDS ST
Practice Address - Street 2:5502 BOUNDS STREET
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-1202
Practice Address - Country:US
Practice Address - Phone:540-455-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management