Provider Demographics
NPI:1427616945
Name:TRUJILLO, ANN JOCELYN
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:JOCELYN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 E I 80 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-8781
Mailing Address - Country:US
Mailing Address - Phone:307-757-7977
Mailing Address - Fax:
Practice Address - Street 1:3304 E I 80 SERVICE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-8781
Practice Address - Country:US
Practice Address - Phone:307-757-7977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator