Individual
ERIC GLEN TREMBATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACAGNP
Contact information
Practice address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407
(612) 863-4000
Mailing address
2020 BRISTOW ST, KANSAS CITY, KS 66103-2111
(816) 719-2565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6308
MN
363LA2100X
Acute Care Nurse Practitioner
6308
MN
363LG0600X
Gerontology Nurse Practitioner
6308
MN
Other
Enumeration date
11/22/2018
Last updated
11/10/2020
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