Provider Demographics
NPI:1689293359
Name:DO, TINA TRAN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:TRAN
Last Name:DO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1805 NEWBURY CT
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5596
Mailing Address - Country:US
Mailing Address - Phone:504-957-5010
Mailing Address - Fax:
Practice Address - Street 1:2500 BELLE CHASSE HWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-7127
Practice Address - Country:US
Practice Address - Phone:504-371-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA213661367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program