Provider Demographics
NPI:1700343696
Name:SEIFERT, TRINA MARIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:MARIE
Last Name:SEIFERT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:MARIE
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 MAIN ST NW STE M
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-4866
Mailing Address - Country:US
Mailing Address - Phone:505-916-0533
Mailing Address - Fax:505-916-0869
Practice Address - Street 1:1400 MAIN ST NW STE M
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-4866
Practice Address - Country:US
Practice Address - Phone:505-916-0533
Practice Address - Fax:505-916-0869
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM55328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily