Healthcare Provider Details

I. General information

NPI: 1467876540
Provider Name (Legal Business Name): TRINA SMITH STRICKLAND NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 NEW YORK ST
MEMPHIS TN
38104-5536
US

IV. Provider business mailing address

886 SALEM AVE
HOLLY SPRINGS MS
38635-2128
US

V. Phone/Fax

Practice location:
  • Phone: 901-728-5858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0114649
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: