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Individual
MS. KIM LAUREN TRAHAN
Active
Individual
MS. KIM LAUREN TRAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006561-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970020849
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039830
PA MEDICARE GROUP
PA
Enumeration date
02/23/2006
Last updated
11/20/2024
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