Provider Demographics
NPI:1235435827
Name:TRAPP, LANNETTE (CRNA)
Entity Type:Individual
Prefix:
First Name:LANNETTE
Middle Name:
Last Name:TRAPP
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 SALT LICK RD
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-0909
Mailing Address - Country:US
Mailing Address - Phone:502-649-5415
Mailing Address - Fax:502-588-0326
Practice Address - Street 1:3107 SALT LICK RD
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-0909
Practice Address - Country:US
Practice Address - Phone:502-649-5415
Practice Address - Fax:502-588-0326
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1112572367500000X
KY3006876367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY086980OtherAANA
KY3006876OtherAPRN LICENS