Individual
JONATHAN TRAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 COUNTRY CLUB RD, CARRIERE, MS 39426-9037
(601) 799-4777
Mailing address
200 COUNTRY CLUB RD, CARRIERE, MS 39426-9037
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
901907
MS
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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