Individual
MYLAN PHAM DANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000
Mailing address
1331 BURGESS DR, MARRERO, LA 70072-5978
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
241818
LA
Other
Enumeration date
06/19/2025
Last updated
06/20/2025
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