Provider Demographics
NPI:1306698196
Name:BRODIE, TRINA
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:BRODIE
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 1:1505 BRUCE PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2919
Mailing Address - Country:US
Mailing Address - Phone:202-607-3508
Mailing Address - Fax:
Practice Address - Street 1:1505 BRUCE PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2919
Practice Address - Country:US
Practice Address - Phone:202-607-3508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide