Provider Demographics
NPI:1205125531
Name:TRAN, KIM-ANH N (MD)
Entity type:Individual
Prefix:
First Name:KIM-ANH
Middle Name:N
Last Name:TRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD.
Mailing Address - Street 2:STE. S250
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-349-6207
Mailing Address - Fax:504-349-6272
Practice Address - Street 1:1111 MEDICAL CENTER BLVD.
Practice Address - Street 2:STE. S250
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-349-6207
Practice Address - Fax:504-349-6272
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.207227207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2188267Medicaid
LA2188267Medicaid