Individual
EMILY JEAN TRENTADUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 W DREXEL AVE STE 300, OAK CREEK, WI 53154-2060
(414) 771-6780
(414) 238-2424
Mailing address
2885 N MAYFAIR RD, WAUWATOSA, WI 53222-4404
(414) 771-6780
(414) 238-2424
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2037-023
WI
363A00000X
Physician Assistant
Primary
2037-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42888500
—
WI
Enumeration date
08/04/2006
Last updated
06/14/2019
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