Healthcare Provider Details

I. General information

NPI: 1023699733
Provider Name (Legal Business Name): ALLIE GRACE TRUDEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 PATTERSON RD
GRAND JUNCTION CO
81506-8818
US

IV. Provider business mailing address

2698 PATTERSON RD
GRAND JUNCTION CO
81506-8818
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-2195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberTL.0008748
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: