Provider Demographics
NPI:1043504095
Name:LEE, LAURIE TRAHAN (ANP-BC)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:TRAHAN
Last Name:LEE
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BENDEL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2922
Mailing Address - Country:US
Mailing Address - Phone:337-232-5864
Mailing Address - Fax:227-269-8854
Practice Address - Street 1:227 BENDEL RD
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2922
Practice Address - Country:US
Practice Address - Phone:337-232-5864
Practice Address - Fax:227-269-8854
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06465363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health