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General NPI Number Information
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NPI Number | 1689462608
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTHCARE PRACTICE, LLC
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2810 FRANK SCOTT PKWY W STE 708
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City | BELLEVILLE
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State | IL
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Zip | 62223-5007
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Country | US
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Telephone | 314-252-8704
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Fax | 618-416-1252
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Provider Business Mailing Address
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Address Line | 2810 FRANK SCOTT PKWY W STE 708
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City | BELLEVILLE
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State | IL
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Zip | 62223-5007
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Country | US
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Telephone | 314-252-8704
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Fax | 618-641-9470
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Authorized Official
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Title or Position | CEO
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Name | TINA TERESA MOND
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Credential | DNP, APRN-FPA
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Telephone | 314-252-8704
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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 |
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License Number State |
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