Provider Demographics
NPI:1356433635
Name:TRENHOLM, KERI COLLEEN (RN, FNP)
Entity type:Individual
Prefix:MS
First Name:KERI
Middle Name:COLLEEN
Last Name:TRENHOLM
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:COLLEEN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7104 N SEWARD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5840
Mailing Address - Country:US
Mailing Address - Phone:541-760-8064
Mailing Address - Fax:
Practice Address - Street 1:9900 BREN RD E
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9664
Practice Address - Country:US
Practice Address - Phone:855-247-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005966363LF0000X
OR200150143NP FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily