Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | AP129500 | TX |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP129500 | TX |
NPI | 1467824433 |
---|---|
Provider Name | Brandi Renee Trujillo |
First Address | Arlington, TX 76014-2075 |
Second Address | Fort Worth, TX 76132-4127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2015 |
Last Update Date | 01/04/2021 |