Individual
TRAVION TEQUILLA RENEE LABRANCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
295 CASTLE DR, EDGARD, LA 70049-2523
(504) 360-3424
Mailing address
PO BOX 5, EDGARD, LA 70049-0005
(504) 360-3424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280123
LA
372500000X
Chore Provider
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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