Provider Demographics
NPI:1386227817
Name:TRAN, ABIGAIL CHRISTINE (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHRISTINE
Last Name:TRAN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:CHRISTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:7000 FERN AVE APT 45
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4962
Mailing Address - Country:US
Mailing Address - Phone:813-943-9520
Mailing Address - Fax:
Practice Address - Street 1:7000 FERN AVE APT 45
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4962
Practice Address - Country:US
Practice Address - Phone:813-943-9520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287382133V00000X
FLND9965133V00000X
LA3620133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered