Provider Demographics
NPI:1912975756
Name:TRUEBLOOD, JANELLE AP (MD)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:AP
Last Name:TRUEBLOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BUNKER HILL DR
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-1865
Mailing Address - Country:US
Mailing Address - Phone:218-927-2157
Mailing Address - Fax:218-927-4130
Practice Address - Street 1:200 BUNKER HILL DR
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-1865
Practice Address - Country:US
Practice Address - Phone:218-927-2157
Practice Address - Fax:218-927-4130
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080011614OtherMEDICARE WPS - AITKIN CLI
MN080015848OtherMEDIARE WPS - GARRISON CL
MN652690000Medicaid
MN080011613OtherMEDICARE WPS - HOSPITAL
MN080011615OtherMEDICARE WPS - MCGREGOR C
H23062Medicare UPIN