Healthcare Provider Details

I. General information

NPI: 1659840056
Provider Name (Legal Business Name): ROBIN BROWNE TRAHAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2018
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 OAK PARK BLVD
LAKE CHARLES LA
70601-7864
US

IV. Provider business mailing address

2110 OAK PARK BLVD
LAKE CHARLES LA
70601-7864
US

V. Phone/Fax

Practice location:
  • Phone: 337-475-0324
  • Fax: 337-475-8917
Mailing address:
  • Phone: 337-475-0324
  • Fax: 337-475-8917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number125170
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: