Provider Demographics
NPI:1316403363
Name:TRUJILLO, AMBER S (CPNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:S
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 E CHAUNCEY LN STE 225
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-3117
Mailing Address - Country:US
Mailing Address - Phone:480-585-5200
Mailing Address - Fax:480-585-5200
Practice Address - Street 1:3050 N LITCHFIELD RD STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7805
Practice Address - Country:US
Practice Address - Phone:480-585-5200
Practice Address - Fax:480-585-5200
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN212818163WS0200X
AZ322329363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WS0200XNursing Service ProvidersRegistered NurseSchool