=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083611123
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROSANN TRIMMER CRNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2005
-----------------------------------------------------
Last Update Date | 03/18/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 MARKET ST STE 1100
-----------------------------------------------------
City | STEUBENVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43952-2874
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-284-1779
-----------------------------------------------------
Fax | 740-284-7146
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 380 SUMMIT AVE MSO PHYSICIAN BILLING
-----------------------------------------------------
City | STEUBENVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43952-2667
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-283-7776
-----------------------------------------------------
Fax | 740-283-7190
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.05262
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------