Provider Demographics
NPI:1831982388
Name:TRENT, RIKELLE TYRA (DO)
Entity type:Individual
Prefix:
First Name:RIKELLE
Middle Name:TYRA
Last Name:TRENT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RIKELLE
Other - Middle Name:TYRA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2050 E WISCONSIN AVE APT 338
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5357
Mailing Address - Country:US
Mailing Address - Phone:973-732-8999
Mailing Address - Fax:
Practice Address - Street 1:2450 S TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5069
Practice Address - Country:US
Practice Address - Phone:575-556-6489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program