Bodenstadt, Trista

Bodenstadt, Trista is an individual health care provider with primary practice located at 1724 State St , New Albany IN 47150-4916. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bodenstadt, Trista can be contacted via phone (502) 327-9100.

Contact Information

Primary practice address
1724 State St New Albany IN 47150-4916
Phone: (502) 327-9100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71012095A Indiana

Profile Details

NPI number 1205597515
LBN Legal business name Bodenstadt, Trista
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2022
Last updated Oct 12th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205597515 NPPES
Kentucky MEDICAID 7100852640

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