Provider Demographics
NPI:1235484262
Name:TRUJILLO, MERRY CHRISTINE (EMT-I)
Entity Type:Individual
Prefix:
First Name:MERRY
Middle Name:CHRISTINE
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:EMT-I
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:TRUIJILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EMIT-I
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:20 OLAVARRIA STREET
Mailing Address - City:MC DERMITT
Mailing Address - State:NV
Mailing Address - Zip Code:89421-0297
Mailing Address - Country:US
Mailing Address - Phone:775-532-8530
Mailing Address - Fax:775-532-8531
Practice Address - Street 1:20 OLAVARRIA STREET
Practice Address - Street 2:
Practice Address - City:MC DERMITT
Practice Address - State:NV
Practice Address - Zip Code:89421-0297
Practice Address - Country:US
Practice Address - Phone:775-532-8530
Practice Address - Fax:775-532-8531
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20294146M00000X
I0702286146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate