Provider Demographics
NPI:1679395958
Name:PERRY, TRINISHA
Entity type:Individual
Prefix:
First Name:TRINISHA
Middle Name:
Last Name:PERRY
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 1:6649 WOODS ISLAND CIR APT 106
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-1479
Mailing Address - Country:US
Mailing Address - Phone:772-288-2992
Mailing Address - Fax:772-288-2999
Practice Address - Street 1:1815 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-7204
Practice Address - Country:US
Practice Address - Phone:772-288-2992
Practice Address - Fax:772-288-2999
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9397526163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn