Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | DR.0065727 | CO |
NPI | 1174900351 |
---|---|
Provider Name | Laura Elizabeth Trujillo |
First Address | Kansas City, MO 64180-0022 |
Second Address | Colorado Springs, CO 80907-6865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2015 |
Last Update Date | 21/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000191998 | (05) | CO |