Moore, Trenita Lashawn

Moore, Trenita Lashawn is an individual health care provider with primary practice located at 200 W Railroad St , Long Beach MS 39560-4517. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Moore, Trenita Lashawn can be contacted via phone (228) 864-0622.

Contact Information

Primary practice address
200 W Railroad St Long Beach MS 39560-4517
Phone: (228) 864-0622
Fax: (228) 864-7958
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R862256 Mississippi

Profile Details

NPI number 1225239411
LBN Legal business name Moore, Trenita Lashawn
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Jan 21st, 2021 - about 5 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 1225239411 NPPES
Mississippi MEDICAID 0620608060

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