Kaitlyn Rose Trevino, ACCNS-P

Primary specialty

Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X

License

1096921 Issued in TX

Practice address

1935 Medical District Dr
Dallas, TX 75235-7701

Phone

(214) 456-1814

NPI assigned

Oct 21, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kaitlyn Rose Radius Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1447977327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7313 NORMANDY RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761125341",
            "telephone_number": "616-915-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "credential": "ACCNS-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "TX",
            "license": "1096921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "RADIUS",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haldo Trevino II
• Hilary Gail Trevino, NP
• Ivan Trevino Jr.
• Jason Trevino, LVN
• Jose Guillermo Trevino, M.D.
• Kenneth Trevino, PH.D.
• Maria Trevino, LCSW
• Mary Guadalupe Trevino, COTA
• Megan Elise Trevino, DPT
• Sierra Lamar Trevino, PA-C

• Pediatric Clinical Nurse Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Pediatric Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.