Healthcare Provider Details

I. General information

NPI: 1306457379
Provider Name (Legal Business Name): TRAM TRAN FRUGE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 08/19/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8595 PICARDY AVE STE 203
BATON ROUGE LA
70809-3670
US

IV. Provider business mailing address

8595 PICARDY AVE STE 203
BATON ROUGE LA
70809-3670
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-7077
  • Fax:
Mailing address:
  • Phone: 225-387-7077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number212269
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: