=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295346443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRENTEN GERALD HALE MSN, APRN, PMHNP-BC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2020
-----------------------------------------------------
Last Update Date | 06/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1062B WELLINGTON WAY
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40513-1200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-219-9399
-----------------------------------------------------
Fax | 859-219-2398
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5200 COMMERCE CROSSINGS DR FL 3
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40229-2182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-253-4924
-----------------------------------------------------
Fax | 502-489-5750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 3014942
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------