Provider Demographics
NPI:1548627821
Name:RASPBERRY, TRENETTE
Entity type:Individual
Prefix:
First Name:TRENETTE
Middle Name:
Last Name:RASPBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 SIR LORDS LN
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1441
Mailing Address - Country:US
Mailing Address - Phone:314-972-8774
Mailing Address - Fax:
Practice Address - Street 1:7406 SIR LORDS LN
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1441
Practice Address - Country:US
Practice Address - Phone:314-972-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide