Provider Demographics
NPI:1740056894
Name:TRIDENT HEALTH SOLUTIONS, LLC
Entity type:Organization
Organization Name:TRIDENT HEALTH SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELSHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:757-297-6750
Mailing Address - Street 1:1015 EDEN WAY N STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2787
Mailing Address - Country:US
Mailing Address - Phone:812-329-9126
Mailing Address - Fax:757-609-3743
Practice Address - Street 1:1015 EDEN WAY N STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2787
Practice Address - Country:US
Practice Address - Phone:757-297-6750
Practice Address - Fax:757-609-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care