Provider Demographics
NPI:1609606748
Name:TRUDEL, ANNETTE E
Entity type:Individual
Prefix:MISS
First Name:ANNETTE
Middle Name:E
Last Name:TRUDEL
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 1:5735 WHITAKER RD APT B201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-2909
Mailing Address - Country:US
Mailing Address - Phone:239-331-6708
Mailing Address - Fax:
Practice Address - Street 1:5735 WHITAKER RD APT B201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-2909
Practice Address - Country:US
Practice Address - Phone:239-331-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11027221363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner