=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568767044
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TRINETTE MCLAIN-WESSEH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2011
-----------------------------------------------------
Last Update Date | 12/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3800 PARK NICOLLET BLVD
-----------------------------------------------------
City | ST LOUIS PARK
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55416-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-993-3123
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13779 43RD ST NE
-----------------------------------------------------
City | SAINT MICHAEL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55376-7603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-396-8671
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | A0910095
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 5013318
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------