DR. NAN C TRUITT


Address: 265 Phalen Blvd, Saint Paul, MN 55130-2400
Phone: 6514956603

DR. NAN C TRUITT (NPI# 1629150479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629150479
Entity Type Individual
Full Name DR. NAN C TRUITT
Other Name NAN C BOLSINGER
Credential PH.D., LP
Practice Address 265 Phalen Blvd
Saint Paul
MN 55130-2400
Mailing Address 2925 Chicago Ave
Minneapolis
MN 55407-1321
Practice Telephone 6514956603
Mailing Telephone 6122625000
Enumeration Date 2006-10-20
Last Update Date 2019-10-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 5880 MN Behavioral Health & Social Service Providers
N 103G00000X Clinical Neuropsychologist 593 AK Behavioral Health & Social Service Providers
N 103TA0400X Psychologist
Specialization: Addiction (Substance Use Disorder)
593 AK Behavioral Health & Social Service Providers
N 103TC0700X Psychologist
Specialization: Clinical
593 AK Behavioral Health & Social Service Providers
N 103TF0200X Psychologist
Specialization: Forensic
593 AK Behavioral Health & Social Service Providers
N 103TM1800X Psychologist
Specialization: Mental Retardation & Developmental Disabilities
593 AK Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
AK 1029222 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
480 Osborne Rd Ne Ste 260, Fridley, MN 55432 9072777444 9072777455

Office Location

Street Address 265 PHALEN BLVD
City SAINT PAUL
State MN
Zip Code 55130-2400

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164904587 Confident Care LLC In Home Supportive Care 1040 Arkwright Street, Saint Paul, MN 55130 2018-09-01
1881015253 Lucas Bosco Wanga Psychologist 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 2014-01-02
1174865570 Sarang Patel Internal Medicine 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 2013-03-23
1427394501 Zongxee Lee Registered Nurse 1072 Payne Ave, St. Paul, MN 55130 2012-12-18
1740532753 One Stop Medical Supply Inc Durable Medical Equipment & Medical Supplies 1049 Payne Ave Suite C, St Paul, MN 55130 2012-10-15
1689923997 Alexis Simmons Counselor 402 University Ave East, Suite A-127, Saint Paul, MN 55130 2012-08-31
1689804064 Group Health Plan, Inc. Durable Medical Equipment & Medical Supplies 537 Phalen Blvd, Saint Paul, MN 55130 2009-07-21
1477756534 Chad Everett Christensen Chiropractor 1073 Payne Ave, Saint Paul, MN 55130 2007-06-07
1922219021 Qwik Urgent Care Clinic Family Medicine 1239 Payne Avenue, Saint Paul, MN 55130 2007-05-24
1275743981 Yia Vang Technician 1100 Arkwright St., St. Paul, MN 55130 2007-05-23
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1013557057 Erik De Water Clinical Neuropsychologist 1876 Minnehaha Ave W, Saint Paul, MN 55104-1029 2020-01-07
1609333038 Minnesota Neuropsychology, LLC Clinical Neuropsychologist 370 Selby Ave Ste 312, Saint Paul, MN 55102-1884 2019-02-21
1619066446 Kristen Ann Ryan Clinical Neuropsychologist 190 5th St E, Ste. 100, Saint Paul, MN 55101-2666 2006-10-12
1770689705 Gale Valtinson & Associates Pa Clinical Neuropsychologist 423 Warwick St, Saint Paul, MN 55105-2548 2006-09-16
1568473569 Jack B. Schaffer Clinical Neuropsychologist 1790 Goodrich Ave, Saint Paul, MN 55105-1907 2006-08-11
1053936922 Suzanne Moseley Clinical Neuropsychologist 225 Smith Ave N, Saint Paul, MN 55102-2533 2020-06-16
1720540974 Tou Khang Clinical Neuropsychologist 393 Dunlap St N Ste 105, Saint Paul, MN 55104-4211 2019-04-04
1811434038 Sarah Marie Olson Clinical Neuropsychologist 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 2017-01-25
1437576840 Jordan Robinson Clinical Neuropsychologist 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 2014-03-24
1750652350 Kara L Leiser Clinical Neuropsychologist 200 University Ave E, Saint Paul, MN 55101-2507 2012-01-13
Find all providers in SAINT PAUL

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City SAINT PAUL
Zip Code 55130

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Dataset Information

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.

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