Provider Demographics
NPI:1962160036
Name:TRETBAR, CHRISTINA ROSE (RN, CDCES)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ROSE
Last Name:TRETBAR
Suffix:
Gender:
Credentials:RN, CDCES
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:ROSE
Other - Last Name:MACKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-9419
Mailing Address - Fax:
Practice Address - Street 1:3955 56TH ST S STE D
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4845
Practice Address - Country:US
Practice Address - Phone:701-234-3725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2494750163WD0400X
NDR46238163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator