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General NPI Number Information
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NPI Number | 1558245506
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Entity Type | Individual
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Provider Name | SHANEA TREVINO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 160 HERITAGE WAY STE 202
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City | KALISPELL
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State | MT
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Zip | 59901-3127
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Country | US
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Telephone | 406-752-8433
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Fax | 406-756-6768
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Provider Business Mailing Address
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Address Line | 6300 LOCARNO DR APT C
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City | WHITEFISH
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State | MT
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Zip | 59937-3206
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Country | US
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Telephone | 406-260-3967
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 266043
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License Number State | MT
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