Healthcare Provider Details

I. General information

NPI: 1932095148
Provider Name (Legal Business Name): NICOLE TREB FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE SCHWIETERING

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 NORTHWAY DR STE 100
SAINT CLOUD MN
56303-1258
US

IV. Provider business mailing address

2504 OCARINA DR
SAUK RAPIDS MN
56379-4608
US

V. Phone/Fax

Practice location:
  • Phone: 320-251-1775
  • Fax:
Mailing address:
  • Phone: 320-333-9745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12925
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: