Provider Demographics
NPI:1760789812
Name:ST. JULIEN, TRENNESSA
Entity Type:Individual
Prefix:
First Name:TRENNESSA
Middle Name:
Last Name:ST. JULIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 FM 1960 W
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-5044
Mailing Address - Country:US
Mailing Address - Phone:832-722-3129
Mailing Address - Fax:
Practice Address - Street 1:1000 FM 1960 RD W
Practice Address - Street 2:SUITE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2508
Practice Address - Country:US
Practice Address - Phone:832-722-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013415163WH0200X, 163WH1000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No374U00000XNursing Service Related ProvidersHome Health Aide