Provider Demographics
NPI:1881852986
Name:TRUJILLO, JUANITA ANN (APNP)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:ANN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 N ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1150
Mailing Address - Country:US
Mailing Address - Phone:608-265-8488
Mailing Address - Fax:
Practice Address - Street 1:115 N ORCHARD ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1150
Practice Address - Country:US
Practice Address - Phone:608-265-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI831-033101YM0800X
WI841-033163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health