Provider Demographics
NPI:1932663168
Name:TRIGUERO, CARMEN (NP)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:TRIGUERO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 PICARDY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-0640
Mailing Address - Country:US
Mailing Address - Phone:636-578-7871
Mailing Address - Fax:
Practice Address - Street 1:1005 PICARDY LN
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-0640
Practice Address - Country:US
Practice Address - Phone:636-578-7871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018034965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner