Individual provider Active NPI

Christina Trudeau

  • Licensed Practical Nurse
  • Morrisonville, NY
National Provider Identifier
1033828108
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
295044 Issued in NY
Practice address
2155 State Route 22B
Morrisonville, NY 12962-3417
Phone
(518) 563-8000
NPI assigned
Nov 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 295044 NY Primary

Addresses

Primary practice location

2155 State Route 22B
Morrisonville, NY 12962-3417

Mailing address

29 Can Am Dr
Plattsburgh, NY 12901-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
295044NYMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1033828108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 CAN AM DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129017900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 STATE ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEAU",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "295044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisonville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.