| Miss Trista Deloris Clemmer, LPN | |
|
618 S Church St, Grantsburg, WI 54840-7866 | |
| (715) 220-1995 | |
| Not Available |
| Full Name | Miss Trista Deloris Clemmer |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 618 S Church St, Grantsburg, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811164122 | NPI | - | NPPES |
| 3950845470 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 306540-031 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Miss Trista Deloris Clemmer, LPN 618 S Church St, Grantsburg, WI 54840-7866 Ph: (715) 220-1995 | Miss Trista Deloris Clemmer, LPN 618 S Church St, Grantsburg, WI 54840-7866 Ph: (715) 220-1995 |
Sandra Leigh Oachs, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 10772 Zetterberg Rd, Grantsburg, WI 54840 Phone: 715-689-2681 Fax: 715-689-2220 | |
Mrs. Jenna Sue Fickbohm, L.P.N Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 13483 County Road F, Grantsburg, WI 54840 Phone: 651-353-5535 |