Provider Demographics
NPI:1740938836
Name:TRINITY TOTAL WELLNESS
Entity type:Organization
Organization Name:TRINITY TOTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC, PMHNP
Authorized Official - Phone:314-749-6675
Mailing Address - Street 1:16025 PERDIDO CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1770
Mailing Address - Country:US
Mailing Address - Phone:314-749-6675
Mailing Address - Fax:
Practice Address - Street 1:15922 ELDORADO PKWY STE 500
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5880
Practice Address - Country:US
Practice Address - Phone:314-749-6675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251J00000XAgenciesNursing Care