MEDICARE: GERILYN KAY TRULOVE PA-C

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	363A00000X	Physician Assistant	5208	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13955576	OTHER		CAQH

General Provider Information

NPI Number	:	1922212216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERILYN KAY TRULOVE PA-C

Provider Business Mailing Address
First Line	:	708 S COEUR D ALENE LN STE B
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85541-5662
Country	:	US
Telephone Number	:	928-468-8603
Fax Number	:	928-468-8625

Provider Business Practice Location Address
First Line	:	708 S COEUR D ALENE LN STE B
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85541-5662
Country	:	US
Telephone Number	:	928-468-8603
Fax Number	:	928-468-8625

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	09/10/2025

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Directions to “ GERILYN KAY TRULOVE PA-C” Practice Location

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