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General NPI Number Information
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NPI Number | 1285932806
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Entity Type | Individual
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Provider Name | TRINA E NESSELROTTE MSN, APRN, AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/06/2011
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 551 FIELDCREST DR
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City | THE VILLAGES
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State | FL
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Zip | 32162-4600
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Country | US
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Telephone | 352-303-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 3915 SE 25TH ST
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City | BUSHNELL
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State | FL
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Zip | 33513-8769
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Country | US
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Telephone | 352-303-1103
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11018473
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9406150
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | FB9727235
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License Number State | FL
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