Provider Demographics
NPI:1710386123
Name:NOON, TRUDY ALYCE (ADULT NP)
Entity Type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:ALYCE
Last Name:NOON
Suffix:
Gender:F
Credentials:ADULT NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 E OSCEOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1611
Mailing Address - Country:US
Mailing Address - Phone:407-452-3700
Mailing Address - Fax:
Practice Address - Street 1:31861 GATEWAY CENTER BLVD S STE A
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5616
Practice Address - Country:US
Practice Address - Phone:541-652-7215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9201429363LA2200X
WAAP60708435363LF0000X
OR201502243NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health