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General NPI Number Information
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NPI Number | 1841924180
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Entity Type | Individual
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Provider Name | MADISON HALEY TRENT APRN
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 1550 HIGHWAY 15 S STE 240
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City | JACKSON
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State | KY
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Zip | 41339-0709
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Country | US
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Telephone | 606-824-5037
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 HIGHWAY 205
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City | CAMPTON
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State | KY
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Zip | 41301-9790
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Country | US
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Telephone | 606-568-6918
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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 | 3017941
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License Number State | KY
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