Provider Demographics
NPI:1891006045
Name:HUTTON, TRINA MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:MARIE
Last Name:HUTTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:MARIE
Other - Last Name:ENTELISANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:425 W TANNER PL
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-6173
Mailing Address - Country:US
Mailing Address - Phone:352-260-2366
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 100108 ROOM M-602
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-5670
Practice Address - Fax:352-273-5683
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9221896363LA2100X
FL92218962086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002749500Medicaid
FLDR289ZMedicare PIN