Provider Demographics
NPI:1790750693
Name:TREZONA, PEGGY LOUISE (CNS)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:LOUISE
Last Name:TREZONA
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:821 RAYMOND AVE
Mailing Address - Street 2:BAKER COURT SUITE 440
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1503
Mailing Address - Country:US
Mailing Address - Phone:651-642-9317
Mailing Address - Fax:651-642-1908
Practice Address - Street 1:821 RAYMOND AVE
Practice Address - Street 2:BAKER COURT SUITE 440
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1503
Practice Address - Country:US
Practice Address - Phone:651-642-9317
Practice Address - Fax:651-642-1908
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN0743066364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist