Provider Demographics
NPI:1659030807
Name:TREMBECZKI, CHARNELL LEE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHARNELL
Middle Name:LEE
Last Name:TREMBECZKI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 SUNSET AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3590
Mailing Address - Country:US
Mailing Address - Phone:252-266-3164
Mailing Address - Fax:
Practice Address - Street 1:3208 SUNSET AVE STE C
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3590
Practice Address - Country:US
Practice Address - Phone:252-266-3164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCTREM-5QSCK363LF0000X
NC5015507363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily