Provider Demographics
NPI:1922836766
Name:HARKNESS, TRINA L
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:L
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13014 W ASH ST
Mailing Address - Street 2:
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-5365
Mailing Address - Country:US
Mailing Address - Phone:480-938-6706
Mailing Address - Fax:
Practice Address - Street 1:2301 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-5904
Practice Address - Country:US
Practice Address - Phone:602-257-3880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program