Provider Demographics
NPI:1497938369
Name:UJDUR, TRUDY TERREEN (MA, C-FNP)
Entity Type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:TERREEN
Last Name:UJDUR
Suffix:
Gender:F
Credentials:MA, C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:MN
Mailing Address - Zip Code:56175-0015
Mailing Address - Country:US
Mailing Address - Phone:218-310-7421
Mailing Address - Fax:
Practice Address - Street 1:251 5TH ST E
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:MN
Practice Address - Zip Code:56175-1536
Practice Address - Country:US
Practice Address - Phone:507-629-3520
Practice Address - Fax:507-212-8260
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR073412-7363LF0000X
MNCNP3703363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily