Healthcare Provider Details
I. General information
NPI: 1104740596
Provider Name (Legal Business Name): TRINITY VOGT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 E BROADWAY
COLUMBIA MO
65215-0001
US
IV. Provider business mailing address
4431 AZALEA BLOSSOM RD
PINEHURST TX
77362-3207
US
V. Phone/Fax
- Phone: 573-441-5107
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: