MISS TRISTA DELORIS CLEMMER LPN NPI 1811164122

NPI Information

  • NPI: 1811164122
  • Provider Name: MISS TRISTA DELORIS CLEMMER, LPN
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 618 S CHURCH ST
    GRANTSBURG, WI
    ZIP 54840
  • Phone: (715) 220-1995

Map and Directions

Get Directions

NPI Details

MISS Trista Deloris Clemmer, LPN is a licensed practical nurse in Grantsburg, WI. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. MISS Trista Deloris Clemmer, LPN NPI is 1811164122. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

618 S CHURCH ST
GRANTSBURG, WI
ZIP 54840-866
Phone: (715) 220-1995

The enumeration date for this NPI number is 5/15/2008 and was last updated on 5/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse306540-031WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13950845470MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI