Healthcare Provider Details

I. General information

NPI: 1376996728
Provider Name (Legal Business Name): JOSCELYN TROMPETER MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24164 BELLEAU AVE
QUANTICO VA
22134-5106
US

IV. Provider business mailing address

1100 FLEETWOOD CT APT 12
FREDERICKSBURG VA
22401-8108
US

V. Phone/Fax

Practice location:
  • Phone: 703-784-6558
  • Fax:
Mailing address:
  • Phone: 214-717-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: