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General NPI Number Information
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NPI Number | 1508774902
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Entity Type | Individual
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Provider Name | MELISSA JO TREVINO CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 800 E 28TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-3723
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Country | US
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Telephone | 612-863-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 8744 PRESTWICK PKWY N
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City | BROOKLYN PARK
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State | MN
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Zip | 55443-3996
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Country | US
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Telephone | 701-527-7150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3435
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License Number State | MN
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