Provider Demographics
NPI:1346963931
Name:TRETSVEN, TANYA
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:TRETSVEN
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 1:620 E MARYLAND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024-9456
Mailing Address - Country:US
Mailing Address - Phone:715-566-4288
Mailing Address - Fax:
Practice Address - Street 1:620 E MARYLAND ST
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-9456
Practice Address - Country:US
Practice Address - Phone:715-566-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care