Provider Demographics
NPI:1245042597
Name:MCAFEE - TRUJILLO, KORIE (FNP)
Entity type:Individual
Prefix:
First Name:KORIE
Middle Name:
Last Name:MCAFEE - TRUJILLO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KORIE
Other - Middle Name:
Other - Last Name:MCAFEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6335 CASTLE DOME PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3743
Mailing Address - Country:US
Mailing Address - Phone:505-506-9161
Mailing Address - Fax:
Practice Address - Street 1:4801 MCMAHON BLVD NW STE 245
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-5478
Practice Address - Country:US
Practice Address - Phone:505-315-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily