Provider Demographics
NPI:1851364210
Name:PARKER, TRUDI (MD)
Entity Type:Individual
Prefix:MS
First Name:TRUDI
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRUC
Other - Middle Name:KIM
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7595 ANAGRAM DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-7399
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:7595 ANAGRAM DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-7399
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN500972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN255611OtherMIDLANDS CHOICE INC
MN182187OtherUCARE
MN960371052725OtherPREFERRED ONE
MN03M81PAOtherBLUE CROSS BLUE SHIELD OF MINNESOTA
MN410974675OtherAMERICA'S PPO
MN976495100Medicaid
SD9258536OtherDAKOTA CARE
WI34989600Medicaid
IA1851364210Medicaid
MNHP87262OtherHEALTHPARTNERS
MN960371052725OtherPREFERRED ONE
MN03M81PAOtherBLUE CROSS BLUE SHIELD OF MINNESOTA
MNI61939Medicare UPIN
MNHP87262OtherHEALTHPARTNERS
IA1851364210Medicaid
WI007704070Medicare PIN