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NPI Code Detail

MEDICARE: MS. LINDA DIANE TRENT FNP

MEDICARE:  MS. LINDA DIANE TRENT  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianR786571MS

General Provider Information

NPI Number : 1730178344
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA DIANE TRENT FNP
Provider Business Mailing Address
First Line : 5675 CENTER HILL RD
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654-8613
Country : US
Telephone Number : 662-895-8377
Fax Number :
Provider Business Practice Location Address
First Line : 9075 SANDIDGE CENTER COVE
Second Line :
City : OLIVE BRANCH
State : MS
Zip : 38654
Country : US
Telephone Number : 662-895-4949
Fax Number : 662-895-6776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 07/09/2007

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Directions to “ MS. LINDA DIANE TRENT FNP” Practice Location

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