Provider Demographics
NPI:1487809653
Name:COLAW, TRUDY MARCELLE (NP)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:MARCELLE
Last Name:COLAW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TRUDY
Other - Middle Name:MARCELLE
Other - Last Name:GUTSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-689-1110
Mailing Address - Fax:540-689-1119
Practice Address - Street 1:2010 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-1110
Practice Address - Fax:540-689-1119
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61520467363L00000X
VA0024168064363LF0000X
NC5006641363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487809653Medicaid
VA1487809653Medicaid