| 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  |