Provider Demographics
NPI:1528553989
Name:TRAHAN, BRITTANY ANN (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ASU DRIVE
Mailing Address - Street 2:#510
Mailing Address - City:LORMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39096-7500
Mailing Address - Country:US
Mailing Address - Phone:601-877-6514
Mailing Address - Fax:
Practice Address - Street 1:1000 ASU DRIVE
Practice Address - Street 2:#510
Practice Address - City:LORMAN
Practice Address - State:MS
Practice Address - Zip Code:39096-7500
Practice Address - Country:US
Practice Address - Phone:601-877-6514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2002022255A2300X
MSAT09012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer