Provider Demographics
NPI:1811498199
Name:TREPANIER, DIANE MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:TREPANIER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 BEACON VIEW DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-7704
Mailing Address - Country:US
Mailing Address - Phone:360-672-2751
Mailing Address - Fax:
Practice Address - Street 1:311 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3427
Practice Address - Country:US
Practice Address - Phone:360-678-2273
Practice Address - Fax:360-678-8715
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001808363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology