Bearden, Trudy
Bearden, Trudy is an individual health care provider with primary practice located at 465 Memorial Dr , Pocatello ID 83209-0001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bearden, Trudy can be contacted via phone (208) 282-4700.Contact Information
Primary practice address
465 Memorial Dr
Pocatello ID 83209-0001
Phone: (208) 282-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA-543 | Idaho |
Profile Details
| NPI number | 1639151848 |
|---|---|
| LBN Legal business name | Bearden, Trudy |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Aug 1st, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639151848 | NPPES |
| Idaho | Other | PA-543 | PA LICENSE NUMBER |
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