Provider Demographics
NPI:1841924180
Name:TRENT, MADISON HALEY (APRN)
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:HALEY
Last Name:TRENT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 HIGHWAY 205
Mailing Address - Street 2:
Mailing Address - City:CAMPTON
Mailing Address - State:KY
Mailing Address - Zip Code:41301-9790
Mailing Address - Country:US
Mailing Address - Phone:606-568-6918
Mailing Address - Fax:
Practice Address - Street 1:1550 HIGHWAY 15 S STE 240
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:KY
Practice Address - Zip Code:41339-0709
Practice Address - Country:US
Practice Address - Phone:606-824-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017941363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily