Active NPI
Mary Ann Truog, R.N.
- Registered Nurse
- Brookfield, WI
National Provider Identifier
1134480023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 64479-30
- Practice address
- 2360 Lilly Rd
Brookfield, WI 53005-4900 - Phone
- (262) 827-4247
- Fax
- (262) 827-4247
- NPI assigned
- Jun 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 64479-30 | WI | Primary |
Addresses
Primary practice location
2360 Lilly Rd
Brookfield, WI 53005-4900
Mailing address
2360 Lilly Rd
Brookfield, WI 53005-4900
Phone (262) 827-4247
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64479-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1134480023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2360 LILLY RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054900",
"telephone_number": "262-827-4247",
"fax_number": "262-827-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2360 LILLY RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054900",
"telephone_number": "262-827-4247",
"fax_number": "262-827-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUOG",
"first_name": "MARY ANN",
"name_prefix": "Mrs.",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-06",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "64479-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.