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NPI Code Detail

MEDICARE: TRAN NGUYEN PHAM FNP-C

MEDICARE: TRAN NGUYEN PHAM FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner218396LA

General Provider Information

NPI Number : 1164014981
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRAN NGUYEN PHAM FNP-C
Provider Business Mailing Address
First Line : 2900 INDIANA AVE
Second Line :
City : KENNER
State : LA
Zip : 70065-4605
Country : US
Telephone Number : 504-575-3712
Fax Number :
Provider Business Practice Location Address
First Line : 501 ROBERT BLVD
Second Line :
City : SLIDELL
State : LA
Zip : 70458-1667
Country : US
Telephone Number : 866-530-6111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2021
Last Update Date : 02/08/2023

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Directions to “ TRAN NGUYEN PHAM FNP-C” Practice Location

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