Provider Demographics
NPI:1750337952
Name:TRENT, JAIME NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:NICOLE
Last Name:TRENT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 BAPTISTE DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1377
Mailing Address - Country:US
Mailing Address - Phone:913-294-3851
Mailing Address - Fax:913-294-9033
Practice Address - Street 1:1313 BAPTISTE DR
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1377
Practice Address - Country:US
Practice Address - Phone:913-294-3851
Practice Address - Fax:913-294-9033
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0000062243OtherBCBS OF KS
KS0000062243OtherBCBS OF KS
KS060992Medicare ID - Type UnspecifiedIDENTIFICATION NUMBER