Healthcare Provider Details

I. General information

NPI: 1841432176
Provider Name (Legal Business Name): BRANDY LYNN TREPKOWSKI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 DAWSON ST
SANDUSKY MI
48471-3305
US

IV. Provider business mailing address

120 N DELAWARE ST
SANDUSKY MI
48471-1009
US

V. Phone/Fax

Practice location:
  • Phone: 810-648-2232
  • Fax: 810-648-0053
Mailing address:
  • Phone: 810-648-3770
  • Fax: 810-648-3352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704243789
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: