Provider Demographics
NPI:1376190793
Name:TRIMNELL, MARQUITTA CRYSTAL (APRN)
Entity Type:Individual
Prefix:DR
First Name:MARQUITTA
Middle Name:CRYSTAL
Last Name:TRIMNELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 COUNTY ROAD 42 W STE 217
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6933
Mailing Address - Country:US
Mailing Address - Phone:952-303-6832
Mailing Address - Fax:
Practice Address - Street 1:2800 COUNTY ROAD 42 W STE 217
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6933
Practice Address - Country:US
Practice Address - Phone:612-721-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6941363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health