Provider Demographics
NPI:1437926664
Name:TREMBLAY, MARTHEA PEARL (LPN)
Entity Type:Individual
Prefix:
First Name:MARTHEA
Middle Name:PEARL
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 SW HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2492
Mailing Address - Country:US
Mailing Address - Phone:785-266-4100
Mailing Address - Fax:
Practice Address - Street 1:3360 SW HARRISON ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2492
Practice Address - Country:US
Practice Address - Phone:785-266-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS233525021164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse