Provider Demographics
NPI:1932975489
Name:STUART, TRINA L (RCP)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:L
Last Name:STUART
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PARK PLACE DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2523
Mailing Address - Country:US
Mailing Address - Phone:573-375-0621
Mailing Address - Fax:
Practice Address - Street 1:301 PARK PLACE DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-2523
Practice Address - Country:US
Practice Address - Phone:573-375-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1283672279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care