| Doctor Name: | MRS. IRMA TRUJILLO |
| NPI Number: | 1598140824 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BILLER |
| License Number: | |
| Business Practice Address: | 201 Broadway Ave Columbus, NM - 88029 |
| Business Phone Number: | 5755445421 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1597, COLUMBUS |
| State: | NM |
| Postal Code: | 880291597 |
| Phone Number: | 7202248668 |
| Fax Number: | |
| NPI Enumeration Date: | 07/28/2015 |
| NPI Last Update Date: | 07/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |