Provider Demographics
NPI:1962607291
Name:RAY, TRENDA DAYLE (APN)
Entity type:Individual
Prefix:MRS
First Name:TRENDA
Middle Name:DAYLE
Last Name:RAY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:2 EPERNAY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223
Mailing Address - Country:US
Mailing Address - Phone:501-868-4706
Mailing Address - Fax:501-364-5869
Practice Address - Street 1:800 MARSHALL ST
Practice Address - Street 2:SLOT 667
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3510
Practice Address - Country:US
Practice Address - Phone:501-364-4506
Practice Address - Fax:501-364-6710
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2009-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARA01477363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics