Provider Demographics
NPI:1376724476
Name:TRAMMELL, INDIA (LPN)
Entity Type:Individual
Prefix:
First Name:INDIA
Middle Name:
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 GREENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:N PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3920
Mailing Address - Country:US
Mailing Address - Phone:800-950-6066
Mailing Address - Fax:
Practice Address - Street 1:182 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:N PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3920
Practice Address - Country:US
Practice Address - Phone:800-950-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05712100164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse