Provider Demographics
NPI:1194360081
Name:TAPPER, TRUDIE (LPN)
Entity type:Individual
Prefix:
First Name:TRUDIE
Middle Name:
Last Name:TAPPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-3523
Mailing Address - Country:US
Mailing Address - Phone:914-513-6917
Mailing Address - Fax:
Practice Address - Street 1:872 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-3523
Practice Address - Country:US
Practice Address - Phone:914-513-6917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY326477-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse