Provider Demographics
NPI:1831838408
Name:SCARBOROUGH, TRISHA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:MARIE
Last Name:SCARBOROUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:MARIE
Other - Last Name:TOWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3619 CURRAN AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1242
Mailing Address - Country:US
Mailing Address - Phone:308-850-7969
Mailing Address - Fax:
Practice Address - Street 1:3563 PRAIRIEVIEW ST STE 300
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4442
Practice Address - Country:US
Practice Address - Phone:308-381-0162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant