Provider Demographics
NPI:1417420902
Name:TRUDEAU, ALEXANDRA EMERY (MS, AGACNP-BC, CNOR)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:EMERY
Last Name:TRUDEAU
Suffix:
Gender:F
Credentials:MS, AGACNP-BC, CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16537 SOUTHWEST FWY STE 500
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7244
Mailing Address - Country:US
Mailing Address - Phone:281-274-7595
Mailing Address - Fax:
Practice Address - Street 1:16537 SOUTHWEST FWY STE 500
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7244
Practice Address - Country:US
Practice Address - Phone:281-274-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140057363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP140057OtherADVANCED PRACTICE REGISTERED NURSE, NURSE PRACTITIONER - ACUTE CARE ADULT/GERO
TX804383OtherREGISTERED NURSE
TX804383OtherREGISTERED NURSE