Provider Demographics
NPI:1982274254
Name:TRENT, CALLIE ANN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:ANN ELIZABETH
Last Name:TRENT
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:ANN ELIZABETH
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1419 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2722
Mailing Address - Country:US
Mailing Address - Phone:606-523-3021
Mailing Address - Fax:606-528-7169
Practice Address - Street 1:1419 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2722
Practice Address - Country:US
Practice Address - Phone:606-523-3021
Practice Address - Fax:606-528-7169
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5231363A00000X
KYPA3351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant