Provider Demographics
NPI:1699448043
Name:TRAN, DARRIEN PHILLIP (FNP)
Entity type:Individual
Prefix:
First Name:DARRIEN
Middle Name:PHILLIP
Last Name:TRAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLYNNE
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-2250
Mailing Address - Country:US
Mailing Address - Phone:609-560-7085
Mailing Address - Fax:
Practice Address - Street 1:75 W RED BANK AVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1694
Practice Address - Country:US
Practice Address - Phone:856-863-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01162500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily