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General NPI Number Information
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NPI Number | 1578705364
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Entity Type | Individual
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Provider Name | JENNIFER TRAINOR APRN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 2468 CORRALES RD. SUITE A, BUILDING A
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City | CORRALES
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State | NM
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Zip | 87048-9148
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Country | US
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Telephone | 505-508-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 620 1/2 ALTO ST
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City | SANTA FE
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State | NM
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Zip | 87501-2519
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Country | US
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Telephone | 561-690-8569
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11010336
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP3248
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP01844
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License Number State | NM
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