Provider Demographics
NPI:1871800714
Name:TRUNECEK, JILL ANN (NP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:TRUNECEK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4758
Mailing Address - Country:US
Mailing Address - Phone:303-930-7803
Mailing Address - Fax:033-930-5503
Practice Address - Street 1:4715 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1385
Practice Address - Country:US
Practice Address - Phone:303-684-1900
Practice Address - Fax:303-684-1925
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375182041363LA2200X
COAPN.0990308-NP363L00000X
CA95000761363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO25030787Medicaid
CO25030787Medicaid