Provider Demographics
NPI:1023893328
Name:DENJEN, TRICIA MARIE (APRN-C)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:MARIE
Last Name:DENJEN
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MEADOW VIEW LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-2906
Mailing Address - Country:US
Mailing Address - Phone:130-468-5057
Mailing Address - Fax:
Practice Address - Street 1:146 MEADOW VIEW LN
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-2906
Practice Address - Country:US
Practice Address - Phone:130-468-5057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV117276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily