Provider Demographics
NPI:1104360551
Name:TREJO-MONSON, CHRISTINE (LAC RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TREJO-MONSON
Suffix:
Gender:F
Credentials:LAC RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WEST RD
Mailing Address - Street 2:
Mailing Address - City:CIRCLE PINES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1622
Mailing Address - Country:US
Mailing Address - Phone:612-669-4313
Mailing Address - Fax:612-884-9597
Practice Address - Street 1:843 W BROADWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-3773
Practice Address - Country:US
Practice Address - Phone:612-669-4313
Practice Address - Fax:612-884-9597
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-118608-8163W00000X
MN1915171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse