Healthcare Provider Details

I. General information

NPI: 1568767044
Provider Name (Legal Business Name): TRINETTE MCLAIN-WESSEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 PARK NICOLLET BLVD
ST LOUIS PARK MN
55416-2527
US

IV. Provider business mailing address

13779 43RD ST NE
SAINT MICHAEL MN
55376-7603
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-3123
  • Fax:
Mailing address:
  • Phone: 612-396-8671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA0910095
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5013318
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: