MEDICARE: PAULA JOSETTE TRUNNELL ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	AP30003872	WA
2	363L00000X	Nurse Practitioner	852920	TX
3	363L00000X	Nurse Practitioner	AP125533	TX
4	363L00000X	Nurse Practitioner	11001904	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386697829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA JOSETTE TRUNNELL ARNP

Provider Business Mailing Address
First Line	:	3098 FOREST HILL BLVD UNIT 1
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-5940
Country	:	US
Telephone Number	:	561-968-7600
Fax Number	:	561-968-0443

Provider Business Practice Location Address
First Line	:	3098 FOREST HILL BLVD UNIT 1
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-5940
Country	:	US
Telephone Number	:	561-968-7600
Fax Number	:	561-968-0443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/06/2023

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