Provider Demographics
NPI:1295346443
Name:HALE, TRENTEN GERALD (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:TRENTEN
Middle Name:GERALD
Last Name:HALE
Suffix:
Gender:M
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:MR
Other - First Name:TRENT
Other - Middle Name:GERALD
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:502-489-5750
Practice Address - Street 1:789 EASTERN BYP STE 23
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2421
Practice Address - Country:US
Practice Address - Phone:859-544-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014942363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3014942OtherKENTUCKY BOARD OF NURSING