Provider Demographics
NPI:1669613956
Name:RICHARD, TRENNA CRAIG (FNP)
Entity type:Individual
Prefix:MRS
First Name:TRENNA
Middle Name:CRAIG
Last Name:RICHARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42078-A VETERANS AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403
Mailing Address - Country:US
Mailing Address - Phone:985-419-1884
Mailing Address - Fax:985-419-1885
Practice Address - Street 1:42078-A VETERANS AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-419-1884
Practice Address - Fax:985-419-1885
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP 2056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily