Provider Demographics
NPI:1063764504
Name:TRIVETTE, JODEE LYNN DEUTSCH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JODEE
Middle Name:LYNN DEUTSCH
Last Name:TRIVETTE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1650 COWLES ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5999
Mailing Address - Country:US
Mailing Address - Phone:907-458-6943
Mailing Address - Fax:
Practice Address - Street 1:1650 COWLES ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5999
Practice Address - Country:US
Practice Address - Phone:907-458-6943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant