Provider Demographics
NPI:1104312479
Name:TREPICONE, MONICA (RN, BSN, MS)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:TREPICONE
Suffix:
Gender:F
Credentials:RN, BSN, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S COLOROW DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1248
Mailing Address - Country:US
Mailing Address - Phone:385-272-2820
Mailing Address - Fax:
Practice Address - Street 1:515 S COLOROW DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1248
Practice Address - Country:US
Practice Address - Phone:385-272-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN290479L163W00000X
OH399631163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse