Healthcare Provider Details

I. General information

NPI: 1831958537
Provider Name (Legal Business Name): EMILY TRAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 N MONTGOMERY AVE
KAPLAN LA
70548-2923
US

IV. Provider business mailing address

PO BOX 493
MAURICE LA
70555-0493
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-6219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number234549
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: