Healthcare Provider Details

I. General information

NPI: 1063086312
Provider Name (Legal Business Name): TRINITY FAMILY HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 MANCHESTER SQUARE SHPG CTR
MANCHESTER KY
40962-8781
US

IV. Provider business mailing address

444 MANCHESTER SQUARE SHPG CTR
MANCHESTER KY
40962-8781
US

V. Phone/Fax

Practice location:
  • Phone: 606-280-4212
  • Fax: 606-215-3816
Mailing address:
  • Phone: 606-280-4212
  • Fax: 606-215-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. REBECCA ANN DAY
Title or Position: OWNER
Credential: DNP
Phone: 606-280-4212