Individual provider · NPI-1

Trina Sue Thursby, ARNP, BSN

Nurse Practitioner, Pediatrics · Crestview, FL

NPI number1295924579
StatusActive
Last updated in NPPESApr 18, 2018

Details

NPI
1295924579
Entity type
Individual (NPI-1)
Name
Mrs. Trina Sue Thursby
Credential
ARNP, BSN
Sex
Female
Sole proprietor
No
Enumeration date
Oct 23, 2007
Last updated
Apr 18, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsARNP3307162FLYes

Practice location

1241 Northview Dr
Crestview, FL 32536-2216

Phone 850-000-0000

Mailing address

1241 Northview Dr
Crestview, FL 32536-2216

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