Provider Demographics
NPI:1871092569
Name:BURY, TRINA LOUISE (NP)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:LOUISE
Last Name:BURY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 E KIMBALL CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-9428
Mailing Address - Country:US
Mailing Address - Phone:801-623-8788
Mailing Address - Fax:
Practice Address - Street 1:3621 E KIMBALL CT
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-9428
Practice Address - Country:US
Practice Address - Phone:801-623-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6307945-4405363LA2100X
AZ279982363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care