Provider Demographics
NPI:1851044713
Name:TREVINO, GENEVA GAY (RN)
Entity Type:Individual
Prefix:
First Name:GENEVA
Middle Name:GAY
Last Name:TREVINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GINNY
Other - Middle Name:
Other - Last Name:TREVINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:279 BEACHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4641
Mailing Address - Country:US
Mailing Address - Phone:269-924-4756
Mailing Address - Fax:
Practice Address - Street 1:4520 BECKLEY RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-7941
Practice Address - Country:US
Practice Address - Phone:269-969-8723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279997163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse