Provider Demographics
NPI:1265773733
Name:TRESVALLES, ANA ROSALIE (FNP)
Entity type:Individual
Prefix:
First Name:ANA ROSALIE
Middle Name:
Last Name:TRESVALLES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S CONROE MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-4722
Mailing Address - Country:US
Mailing Address - Phone:936-539-4004
Mailing Address - Fax:
Practice Address - Street 1:605 S CONROE MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4722
Practice Address - Country:US
Practice Address - Phone:936-539-4004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX711321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily