Provider Demographics
NPI:1245401249
Name:TROMBLEY, KAREN MARCIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARCIA
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 PINECREST LN
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-2044
Mailing Address - Country:US
Mailing Address - Phone:262-723-2010
Mailing Address - Fax:
Practice Address - Street 1:1116 PINECREST LN
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-2044
Practice Address - Country:US
Practice Address - Phone:262-723-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35047500Medicaid