Healthcare Provider Details

I. General information

NPI: 1518843390
Provider Name (Legal Business Name): TRISHA JEFFERSON TATMAN H.I.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ISAIAH DR
LAFAYETTE LA
70508-9003
US

IV. Provider business mailing address

201 ISAIAH DR
LAFAYETTE LA
70508-9003
US

V. Phone/Fax

Practice location:
  • Phone: 337-789-7192
  • Fax:
Mailing address:
  • Phone: 337-789-7192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1239
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: