Healthcare Provider Details

I. General information

NPI: 1104834712
Provider Name (Legal Business Name): TRINA MARIE SETTLES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N MADISON ST
BLOOMFIELD IA
52537-1271
US

IV. Provider business mailing address

509 N MADISON ST
BLOOMFIELD IA
52537-1271
US

V. Phone/Fax

Practice location:
  • Phone: 641-664-2145
  • Fax: 641-664-2058
Mailing address:
  • Phone: 641-664-2145
  • Fax: 641-664-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2001014690
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: