Provider Demographics
NPI:1467482810
Name:TREGNAGO, MARC ANTONY (RN)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:ANTONY
Last Name:TREGNAGO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8809 NE 75TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1047
Mailing Address - Country:US
Mailing Address - Phone:816-792-2960
Mailing Address - Fax:
Practice Address - Street 1:8809 NE 75TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1047
Practice Address - Country:US
Practice Address - Phone:816-792-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO131110163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation