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General NPI Number Information
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NPI Number | 1275231029
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Entity Type | Individual
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Provider Name | TRISHA JEAN STREET APRN
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Gender | Female
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 1200 S PINELLAS AVE STE 10
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3716
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Country | US
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Telephone | 727-275-0028
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Fax |
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Provider Business Mailing Address
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Address Line | 2862 ST CROIX DR
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City | CLEARWATER
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State | FL
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Zip | 33759-2016
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Country | US
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Telephone | 727-871-6585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11024822
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License Number State | FL
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