Healthcare Provider Details

I. General information

NPI: 1720444946
Provider Name (Legal Business Name): JANIE TROSCLAIR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2016
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 W TUNNEL BLVD
HOUMA LA
70360-2794
US

IV. Provider business mailing address

102 W 112TH ST
CUT OFF LA
70345-3628
US

V. Phone/Fax

Practice location:
  • Phone: 985-876-2321
  • Fax:
Mailing address:
  • Phone: 985-632-5222
  • Fax: 985-632-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP08573
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: