Provider Demographics
NPI:1891584165
Name:TRUJILLO, ANGELICA J (FNP)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:J
Last Name:TRUJILLO
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MULBERRY LOOP
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9439
Mailing Address - Country:US
Mailing Address - Phone:505-515-6087
Mailing Address - Fax:
Practice Address - Street 1:35 MULBERRY LOOP
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9439
Practice Address - Country:US
Practice Address - Phone:505-515-6087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM83091363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care