Healthcare Provider Details

I. General information

NPI: 1902813462
Provider Name (Legal Business Name): TRINA GABERT CALDWELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRINA DELYNN GABERT APRN

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2483 I-40 WEST
AMARILLO TX
79109
US

IV. Provider business mailing address

2483 I-40 WEST
AMARILLO TX
79109
US

V. Phone/Fax

Practice location:
  • Phone: 806-463-3200
  • Fax: 806-463-3179
Mailing address:
  • Phone: 806-463-3200
  • Fax: 806-463-3179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number527282
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number527282
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: