Provider Demographics
NPI:1528281300
Name:TRAUTLEIN, JUDE (RD)
Entity type:Individual
Prefix:
First Name:JUDE
Middle Name:
Last Name:TRAUTLEIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 N CAMPBELL AVE
Mailing Address - Street 2:#122
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-3304
Mailing Address - Country:US
Mailing Address - Phone:520-235-0307
Mailing Address - Fax:
Practice Address - Street 1:2764 N WARREN AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-3142
Practice Address - Country:US
Practice Address - Phone:520-235-0307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric