AUDRA L TRUMP (NPI# 1780076901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780076901 |
| Entity Type | Individual |
| Full Name | AUDRA L TRUMP |
| Credential | FNP-C |
| Practice Address |
102 W Kenwood Ave Decatur IL 62526-4368 |
| Practice Telephone | 2178723800 |
| Practice Fax Number | 2178720849 |
| Mailing Telephone | 2178723800 |
| Mailing Fax Number | 2178720849 |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2016-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209-012542 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
102 W KENWOOD AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376534636 | Jeffrey Bruce Rounds | Specialist/Technologist | 102 W Kenwood Ave, Decatur, IL 62526-4300 | 2005-11-04 |
| 1497277263 | Jonathan Roderick Dutt | Family Medicine | 102 W Kenwood Ave, Decatur, IL 62526-4368 | 2017-07-12 |
| 1407376338 | Board of Trustees of Southern Illinois University | Clinic/Center | 102 W Kenwood Ave, Decatur, IL 62526-4368 | 2017-06-21 |
| 1992234504 | Nicole Gabriel Tenegra | Family Medicine | 102 W Kenwood Ave, Decatur, IL 62526-4368 | 2017-06-07 |
| 1811340979 | Aimen Naeem | Family Medicine | 102 W Kenwood Ave, Suite 100, Decatur, IL 62526-4368 | 2016-07-13 |
| 1528411683 | Hema Patel | Family Medicine | 102 W Kenwood Ave, Suite 100, Decatur, IL 62526-4368 | 2016-07-13 |
| 1578914867 | Deepti Sood | Family Medicine | 102 W Kenwood Ave, Suite 100, Decatur, IL 62526-4368 | 2016-06-28 |
| 1780065730 | Zeerak Qureshi | Family Medicine | 102 W Kenwood Ave, Ste 100, Decatur, IL 62526-4368 | 2015-06-16 |
| 1619396736 | Michael Knobeloch | Counselor | 102 W Kenwood Ave, Suite 120a, Decatur, IL 62526-4368 | 2014-04-16 |
| 1932464633 | Alicia Koontz | Physical Therapy Assistant | 102 W Kenwood Ave, Decatur, IL 62526-4368 | 2012-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1790383776 | Angela Tope Adeleke | Nurse Practitioner | 3185 Georgian Woods Cir, Decatur, GA 30034-5105 | 2020-10-13 |
| 1417564147 | Jigna Patel | Nurse Practitioner | 1963 Don Juan Ln, Decatur, GA 30032-4218 | 2020-09-27 |
| 1659983856 | Emilie Carsell Mathias | Nurse Practitioner | 2208 N Crossing Way, Decatur, GA 30033-4175 | 2020-08-19 |
| 1275151078 | Tiffanie Marshall Mcguire | Nurse Practitioner | 2042 Beltline Rd Sw Ste B101, Decatur, AL 35601-5571 | 2020-07-08 |
| 1922623610 | Anastasiya A Drogoul | Nurse Practitioner | 2675 N Decatur Rd Ste 404, Decatur, GA 30033-6133 | 2020-06-09 |
| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.