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General NPI Number Information
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NPI Number | 1134796584
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Entity Type | Individual
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Provider Name | SIMONE TRAHAN MCMILLON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 3100 FORSYTHE AVE
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City | MONROE
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State | LA
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Zip | 71201-3014
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Country | US
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Telephone | 318-966-5450
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Fax | 318-966-5451
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 318-966-5450
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Fax | 225-765-9196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 220854
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN141159
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License Number State | LA
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