Healthcare Provider Details

I. General information

NPI: 1679395958
Provider Name (Legal Business Name): TRINISHA PERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 NEW GARDEN RD
GREENSBORO NC
27410-2721
US

IV. Provider business mailing address

1210 NEW GARDEN RD
GREENSBORO NC
27410-2721
US

V. Phone/Fax

Practice location:
  • Phone: 336-294-6190
  • Fax: 336-294-6278
Mailing address:
  • Phone: 336-294-6190
  • Fax: 336-294-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5024018
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN9397526
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: