Provider Demographics
NPI:1477558351
Name:TRUMBAUER, DENISE S (DNP, APN, BC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:S
Last Name:TRUMBAUER
Suffix:
Gender:F
Credentials:DNP, APN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ANITA DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-7522
Mailing Address - Country:US
Mailing Address - Phone:609-926-8485
Mailing Address - Fax:609-788-8111
Practice Address - Street 1:1156 PIEDMONT RD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-4843
Practice Address - Country:US
Practice Address - Phone:609-432-5417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009647363LA2200X
NJ26NJ00030600363LA2200X
PASP003816C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
067790OtherPROVIDER NUMBER
067790OtherPROVIDER NUMBER