Provider Demographics
NPI:1053603555
Name:TRAN, HONG NHUNG (PA)
Entity type:Individual
Prefix:
First Name:HONG
Middle Name:NHUNG
Last Name:TRAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8585 PICARDY AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3748
Mailing Address - Country:US
Mailing Address - Phone:225-763-4800
Mailing Address - Fax:
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-765-2048
Practice Address - Fax:225-765-1958
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200443363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05684711Medicaid
274670YJA2OtherMEDICARE
LA2152823Medicaid