Healthcare Provider Details

I. General information

NPI: 1033259726
Provider Name (Legal Business Name): REBECCA LYNN TREWYN A.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 06/17/2024
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 LANDMARK PL STE 210
MADISON WI
53713-4200
US

IV. Provider business mailing address

2909 LANDMARK PL STE 210
MADISON WI
53713-4200
US

V. Phone/Fax

Practice location:
  • Phone: 855-458-4966
  • Fax:
Mailing address:
  • Phone: 855-458-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2592-033
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2592-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: