Basic Information
| Provider Information | |||||||||
| NPI: | 1417178021 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUITT | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 9TH ST SE STE 1 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559046400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072883443 | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 9TH ST SE STE 1 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559046400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072883443 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 55965-20 | WI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 49880 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00648846 | 01 | MN | MEDICARE, RAILROAD | OTHER | 763197000 | 05 | MN | MEDICAID |