Provider Demographics
NPI:1912143546
Name:TRUITT, BARBARA SUSAN (RD, LD/N)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:SUSAN
Last Name:TRUITT
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9781 NW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4927
Mailing Address - Country:US
Mailing Address - Phone:954-227-2117
Mailing Address - Fax:
Practice Address - Street 1:9781 NW 23RD CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4927
Practice Address - Country:US
Practice Address - Phone:954-227-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5404133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered