Healthcare Provider Details

I. General information

NPI: 1235435827
Provider Name (Legal Business Name): LANNETTE A TRAPP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 SALT LICK RD
CRESTWOOD KY
40014-0909
US

IV. Provider business mailing address

3107 SALT LICK RD
CRESTWOOD KY
40014-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-649-5415
  • Fax: 502-588-0326
Mailing address:
  • Phone: 502-649-5415
  • Fax: 502-588-0326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1112572
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3006876
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11036785
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: