Provider Demographics
NPI:1871059899
Name:TRENT, ANNA BEAMER (RDN, LDN)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:BEAMER
Last Name:TRENT
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAPTIST MEDICAL CENTER NASSAU
Mailing Address - Street 2:1250 SOUTH 18TH STREET
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034
Mailing Address - Country:US
Mailing Address - Phone:904-321-3700
Mailing Address - Fax:904-391-5344
Practice Address - Street 1:BAPTIST MEDICAL CENTER NASSAU
Practice Address - Street 2:1250 SOUTH 18TH STREET
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034
Practice Address - Country:US
Practice Address - Phone:904-321-3700
Practice Address - Fax:904-391-5344
Is Sole Proprietor?:No
Enumeration Date:2019-02-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7306133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010123100Medicaid