Provider Demographics
NPI:1124445176
Name:CAUGHMAN, TRINA (RN)
Entity type:Individual
Prefix:MS
First Name:TRINA
Middle Name:
Last Name:CAUGHMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 HIGHWAY 178
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:SC
Mailing Address - Zip Code:29160-8649
Mailing Address - Country:US
Mailing Address - Phone:803-568-2314
Mailing Address - Fax:
Practice Address - Street 1:2221 HIGHWAY 178
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:SC
Practice Address - Zip Code:29160-8649
Practice Address - Country:US
Practice Address - Phone:803-568-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22187251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare