Provider Demographics
NPI:1649438581
Name:TRETTON, JACQUELYN LOIS (APN)
Entity type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:LOIS
Last Name:TRETTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W WASHINGTON ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3829
Mailing Address - Country:US
Mailing Address - Phone:775-841-7246
Mailing Address - Fax:775-841-0611
Practice Address - Street 1:550 W WASHINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3829
Practice Address - Country:US
Practice Address - Phone:775-841-7246
Practice Address - Fax:775-841-0611
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily