Healthcare Provider Details

I. General information

NPI: 1801185087
Provider Name (Legal Business Name): TRENA M LINDSEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 LINCOLN ST
EUGENE OR
97405-2775
US

IV. Provider business mailing address

2780 LINCOLN ST
EUGENE OR
97405-2775
US

V. Phone/Fax

Practice location:
  • Phone: 541-359-5112
  • Fax: 541-653-8855
Mailing address:
  • Phone: 541-359-5112
  • Fax: 541-653-8855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number098000397RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: