Provider Demographics
NPI:1740576115
Name:BITZ, TRENT WILLIAM (FNP-C)
Entity Type:Individual
Prefix:
First Name:TRENT
Middle Name:WILLIAM
Last Name:BITZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-3056
Mailing Address - Country:US
Mailing Address - Phone:701-845-8060
Mailing Address - Fax:
Practice Address - Street 1:132 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-3056
Practice Address - Country:US
Practice Address - Phone:701-845-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR33250363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND84094Medicaid
ND84094Medicaid