Provider Demographics
NPI:1912972290
Name:TREBS, DENYSE SAMPSON (RN-CANP)
Entity Type:Individual
Prefix:
First Name:DENYSE
Middle Name:SAMPSON
Last Name:TREBS
Suffix:
Gender:F
Credentials:RN-CANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 PINE TREE DR
Mailing Address - Street 2:PO BOX 135
Mailing Address - City:BIGFORK
Mailing Address - State:MN
Mailing Address - Zip Code:56628-0135
Mailing Address - Country:US
Mailing Address - Phone:218-743-3232
Mailing Address - Fax:218-743-4223
Practice Address - Street 1:135 PINE TREE DR
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MN
Practice Address - Zip Code:56628-0135
Practice Address - Country:US
Practice Address - Phone:218-743-3232
Practice Address - Fax:218-743-4223
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0660644363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4D145OtherMPIN
R92618Medicare UPIN
MN50900252Medicare ID - Type Unspecified
MN4D145OtherMPIN