Provider Demographics
NPI:1598064891
Name:BRIGGS, TRUDY LOUISE (STNA)
Entity type:Individual
Prefix:MS
First Name:TRUDY
Middle Name:LOUISE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 RAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-2128
Mailing Address - Country:US
Mailing Address - Phone:419-552-2319
Mailing Address - Fax:
Practice Address - Street 1:537 RAWSON AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2128
Practice Address - Country:US
Practice Address - Phone:419-552-2319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH501029401005376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide