Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD.201624 | LA |
NPI | 1124297627 |
---|---|
Provider Name | Dr. Erin Trahan Pratt |
First Address | Lafayette, LA 70508-5744 |
Second Address | Lafayette, LA 70508-5744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2008 |
Last Update Date | 21/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1508390 | (05) | LA |
MD.201624 | STATE LICENSE NUMBER (01) | LA |