Individual
DR. NAN C TRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., LP
Contact information
Practice address
265 PHALEN BLVD, SAINT PAUL, MN 55130-2400
(651) 495-6603
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
5880
MN
103G00000X
Clinical Neuropsychologist
593
AK
103TA0400X
Addiction (Substance Use Disorder) Psychologist
593
AK
103TC0700X
Clinical Psychologist
593
AK
103TF0200X
Forensic Psychologist
593
AK
103TM1800X
Intellectual & Developmental Disabilities Psychologist
593
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029222
—
AK
Enumeration date
10/20/2006
Last updated
10/04/2019
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