Provider Demographics
NPI:1093597908
Name:TRUGRACE WOUND CARE, LLC
Entity Type:Organization
Organization Name:TRUGRACE WOUND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COUGER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ANP-C
Authorized Official - Phone:719-466-1827
Mailing Address - Street 1:5142 N ACADEMY BLVD
Mailing Address - Street 2:#1083
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4002
Mailing Address - Country:US
Mailing Address - Phone:719-466-1827
Mailing Address - Fax:
Practice Address - Street 1:5142 N ACADEMY BLVD
Practice Address - Street 2:#1083
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4002
Practice Address - Country:US
Practice Address - Phone:719-466-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty