Healthcare Provider Details

I. General information

NPI: 1013675867
Provider Name (Legal Business Name): KARLA TRUJILLO BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6644 E BAYWOOD AVE
MESA AZ
85206-1747
US

IV. Provider business mailing address

3526 S CHAPARRAL RD
APACHE JUNCTION AZ
85119-3674
US

V. Phone/Fax

Practice location:
  • Phone: 480-321-4731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberRN200791
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: