Healthcare Provider Details

I. General information

NPI: 1548818446
Provider Name (Legal Business Name): LOAN TRAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 VETERANS BLVD STE 101 2109 DAVID DRIVE
METAIRIE LA
70002
US

IV. Provider business mailing address

3848 VETERANS BLVD STE 101
METAIRIE LA
70002
US

V. Phone/Fax

Practice location:
  • Phone: 504-885-2505
  • Fax: 504-885-2510
Mailing address:
  • Phone: 504-885-2505
  • Fax: 504-885-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number207022
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: