Provider Demographics
NPI:1760235774
Name:TRAHAN, JOSH (BSN, RN)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 STATE ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2082
Mailing Address - Country:US
Mailing Address - Phone:615-879-3582
Mailing Address - Fax:
Practice Address - Street 1:222 STATE ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2082
Practice Address - Country:US
Practice Address - Phone:615-879-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN278003163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management