Provider Demographics
NPI:1386269561
Name:TRIFECTA CARE
Entity type:Organization
Organization Name:TRIFECTA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DNP
Authorized Official - Phone:870-395-1285
Mailing Address - Street 1:PO BOX 21194
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71612
Mailing Address - Country:US
Mailing Address - Phone:870-395-1285
Mailing Address - Fax:
Practice Address - Street 1:207 FRANKIE LN
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-2683
Practice Address - Country:US
Practice Address - Phone:870-209-2676
Practice Address - Fax:870-341-6217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Single Specialty