Healthcare Provider Details

I. General information

NPI: 1538850664
Provider Name (Legal Business Name): HANNAH ISTRE RAMBO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH ISTRE DPM

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W BRENTWOOD BLVD STE 2
LAFAYETTE LA
70506-6190
US

IV. Provider business mailing address

203 W BRENTWOOD BLVD STE 2
LAFAYETTE LA
70506-6190
US

V. Phone/Fax

Practice location:
  • Phone: 337-981-4001
  • Fax:
Mailing address:
  • Phone: 337-981-4001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number350641
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: