1518970649 NPI number — MRS. ELIZABETH A TRENT-METZ MSN RNCS FNP 106155

Table of content: MRS. ELIZABETH A TRENT-METZ MSN RNCS FNP 106155 (NPI 1518970649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518970649 NPI number — MRS. ELIZABETH A TRENT-METZ MSN RNCS FNP 106155

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRENT-METZ
Provider First Name:
ELIZABETH
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSN RNCS FNP 106155
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518970649
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 850
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROGERSVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37857-0850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-272-7651
Provider Business Mailing Address Fax Number:
423-272-6177

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 W BROADWAY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROGERSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37857-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-272-7651
Provider Business Practice Location Address Fax Number:
423-272-6177
Provider Enumeration Date:
08/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  APRN7216 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: RN106155 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3729687 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4045020 . This is a "MAGELLAN PINNACLE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4045020 . This is a "MAGELLAN NAVIGATOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4045020 . This is a "MAGELLAN SUMMIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "TRICARE SOUTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 334969 . This is a "VALUE OPTIONS GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 351654200 . This is a "DOL WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "THREE RIVERS PROVI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605Y7 . This is a "UBH JOHN DEERE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3908734 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 620582605 . This is a "MENTAL HEALTH NETW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2246806 . This is a "CIGNA MCC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "INITIAL GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7884520 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com