Provider Demographics
NPI:1255666905
Name:TRUITT, NICOLE ANN (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANN
Last Name:TRUITT
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:RUTLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19070-1801
Mailing Address - Country:US
Mailing Address - Phone:267-934-2704
Mailing Address - Fax:
Practice Address - Street 1:201 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2396
Practice Address - Country:US
Practice Address - Phone:267-934-2704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS