Trista Deloris Clemmer in Grantsburg - Licensed Practical Nurse
Trista Deloris Clemmer - NPI 1811164122
Trista Deloris Clemmer is a Licensed Practical Nurse in Grantsburg, Wisconsin. Trista Deloris Clemmer practices all healthcare services and medical treatments related to Licensed Practical Nurse. The NPI Number for Trista Deloris Clemmer is 1811164122. The last update date is 2008-05-15.
Trista Deloris Clemmer's current location address is 618 S Church St, Grantsburg, Wisconsin. You can contact this provider via phone number 7152201995. The mailing address for Trista Deloris Clemmer is 618 S Church St, Grantsburg, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Trista Deloris Clemmer |
|---|---|
| Address | 618 S Church St, Grantsburg, Wisconsin |
| Phone Number | 7152201995 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LPN |
NPI Number Detail
| NPI Number | 1811164122 |
|---|---|
| Provider Enumeration Date | 2008-05-15 |
| Last Updated Date | 2008-05-15 |
Provider Mailing Address Detail
| Address | 618 S Church St |
|---|---|
| City | Grantsburg |
| State | Wisconsin (WI) |
| Post Code | 548407866 |
| Phone Number | 7152201995 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Practical Nurse |
|---|---|
| Taxonomy | 164W00000X |
| Licence No | 306540-031 |
|
Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job r |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3950845470 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Trista Deloris Clemmer by the Centers for Medicare & Medicaid Services?
The Trista Deloris Clemmer has been issued the NPI (National Provider Identifier) 1811164122 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Trista Deloris Clemmer's facilities are geographically located?
The facilities of Trista Deloris Clemmer are physically situated at the following location: 618 S Church St, Grantsburg, WI, 548407866.
What is Trista Deloris Clemmer's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Trista Deloris Clemmer's specialized field of practice is Licensed Practical Nurse, and the corresponding taxonomy code that categorizes this area of specialization is 164W00000X.
When did the Trista Deloris Clemmer receive its 1811164122?
The Trista Deloris Clemmer was issued its 1811164122 on 2008-05-15, which is the date when the organization was assigned this unique identifier.
When was the Trista Deloris Clemmer's information last updated?
The Trista Deloris Clemmer's information was last updated on 2008-05-15.
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