Provider Demographics
NPI:1053615864
Name:HUTSON, TRINIS
Entity type:Individual
Prefix:MISS
First Name:TRINIS
Middle Name:
Last Name:HUTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9953 LEWIS AND CLARK BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5336
Mailing Address - Country:US
Mailing Address - Phone:314-921-5672
Mailing Address - Fax:314-867-6473
Practice Address - Street 1:9953 LEWIS AND CLARK BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-5336
Practice Address - Country:US
Practice Address - Phone:314-921-5672
Practice Address - Fax:314-867-6473
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-08
Last Update Date:2011-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider