=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891006045
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRINA MARIE HUTTON ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2010
-----------------------------------------------------
Last Update Date | 07/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PO BOX 100108 ROOM M-602
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32610-3003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-273-5670
-----------------------------------------------------
Fax | 352-273-5683
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425 W TANNER PL
-----------------------------------------------------
City | CITRUS SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34434-6173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-260-2366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | ARNP9221896
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2086S0127X
-----------------------------------------------------
Taxonomy Name | Trauma Surgery Physician
-----------------------------------------------------
License Number | 9221896
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------