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General NPI Number Information
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NPI Number | 1063425429
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Entity Type | Individual
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Provider Name | RENO TRUJILLO NP
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-1308
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Country | US
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Telephone | 209-617-6327
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 N COTTAGE TRL # A7
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City | SHOW LOW
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State | AZ
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Zip | 85901-3316
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Country | US
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Telephone | 209-617-6327
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN 505988 NP11030
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN 505988 NP11030
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2459247
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License Number State | MN
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