Provider Demographics
NPI:1699128223
Name:TROTTER, VORNETTA SHA (NP)
Entity type:Individual
Prefix:
First Name:VORNETTA
Middle Name:SHA
Last Name:TROTTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VORNETTA
Other - Middle Name:SHA
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1717 MAIN ST STE 5850
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7317
Mailing Address - Country:US
Mailing Address - Phone:972-833-1148
Mailing Address - Fax:
Practice Address - Street 1:1717 MAIN ST STE 5850
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7317
Practice Address - Country:US
Practice Address - Phone:972-833-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily