Provider Demographics
NPI:1194435263
Name:TRAHAN, ALIX PUYAU (RN)
Entity type:Individual
Prefix:MRS
First Name:ALIX
Middle Name:PUYAU
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-5906
Mailing Address - Country:US
Mailing Address - Phone:337-893-3973
Mailing Address - Fax:
Practice Address - Street 1:608 N ELEAZAR AVE
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-2926
Practice Address - Country:US
Practice Address - Phone:337-643-7965
Practice Address - Fax:337-643-2821
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA206119163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse