Provider Demographics
NPI:1629054838
Name:TRONTVET, SHEILA ANN (CNP PAC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:TRONTVET
Suffix:
Gender:F
Credentials:CNP PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W 13TH ST
Mailing Address - Street 2:UNITY MEDICAL CENTER
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1826
Mailing Address - Country:US
Mailing Address - Phone:701-352-1620
Mailing Address - Fax:701-352-1671
Practice Address - Street 1:164 W 13TH ST
Practice Address - Street 2:GRAFTON FAMILY CLINIC
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1826
Practice Address - Country:US
Practice Address - Phone:701-352-2000
Practice Address - Fax:701-352-1671
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:2006-01-11
Deactivation Code:
Reactivation Date:2007-03-26
Provider Licenses
StateLicense IDTaxonomies
NDPAC0081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN18555OtherFNP
MN18554OtherPAC
MN18555OtherFNP