Provider Demographics
NPI:1376789107
Name:TRUJILLO, CHEYANNA LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHEYANNA
Middle Name:LYNN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4114
Mailing Address - Country:US
Mailing Address - Phone:919-775-1355
Mailing Address - Fax:919-775-1370
Practice Address - Street 1:1007 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6343
Practice Address - Country:US
Practice Address - Phone:919-775-1355
Practice Address - Fax:919-775-1370
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004243363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily