Healthcare Provider Details

I. General information

NPI: 1689562142
Provider Name (Legal Business Name): ROBIN LIEN PHAM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 BETHIA ST
FRANKLIN LA
70538-3720
US

IV. Provider business mailing address

105 LANTANA CT
BROUSSARD LA
70518-7618
US

V. Phone/Fax

Practice location:
  • Phone: 337-828-3507
  • Fax: 337-828-7204
Mailing address:
  • Phone: 337-255-8302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP241984
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: