Provider Demographics
NPI:1649898933
Name:TRENT, MATTIE LEE (FNP)
Entity type:Individual
Prefix:
First Name:MATTIE
Middle Name:LEE
Last Name:TRENT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:MATTIE
Other - Middle Name:ELIZABETH
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2829 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3216
Mailing Address - Country:US
Mailing Address - Phone:423-616-9757
Mailing Address - Fax:844-309-6361
Practice Address - Street 1:2829 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3216
Practice Address - Country:US
Practice Address - Phone:423-616-9757
Practice Address - Fax:844-309-6361
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000230472163W00000X
TN28957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse