Healthcare Provider Details

I. General information

NPI: 1356133391
Provider Name (Legal Business Name): KIMBERLY R TREBIL EMR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N6260 978TH ST
ELLSWORTH WI
54011-4529
US

IV. Provider business mailing address

N6260 978TH ST
ELLSWORTH WI
54011-4529
US

V. Phone/Fax

Practice location:
  • Phone: 651-338-7818
  • Fax:
Mailing address:
  • Phone: 651-338-7818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number983744
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: