Provider Demographics
NPI:1174801047
Name:TROUSKOVA, IOULIA IGOREVNA
Entity type:Individual
Prefix:MS
First Name:IOULIA
Middle Name:IGOREVNA
Last Name:TROUSKOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9953 GROUSE ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5531
Mailing Address - Country:US
Mailing Address - Phone:651-558-7343
Mailing Address - Fax:
Practice Address - Street 1:9953 GROUSE ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5531
Practice Address - Country:US
Practice Address - Phone:651-558-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist