Provider Demographics
NPI:1881479343
Name:TRESTLE MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:TRESTLE MEDICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:VICTORIA MALAVE
Authorized Official - Last Name:EIGENMANN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:806-324-7996
Mailing Address - Street 1:60 ASSEMBLY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:NM
Mailing Address - Zip Code:88347
Mailing Address - Country:US
Mailing Address - Phone:806-324-7996
Mailing Address - Fax:
Practice Address - Street 1:1200 JAMES CANYON HIGHWAY
Practice Address - Street 2:
Practice Address - City:CLOUDCROFT
Practice Address - State:NM
Practice Address - Zip Code:88317
Practice Address - Country:US
Practice Address - Phone:806-324-7996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty