Individual
THAI BAO TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
920 DOUG WHITE DR STE 210, MYRTLE BEACH, SC 29572-4181
(843) 497-6348
(843) 497-6351
Mailing address
920 DOUG WHITE DR STE 210, MYRTLE BEACH, SC 29572-4181
(843) 497-6348
(843) 497-6351
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26043
SC
363L00000X
Nurse Practitioner
5014070
NC
363LA2200X
Adult Health Nurse Practitioner
5014070
NC
363LG0600X
Gerontology Nurse Practitioner
26043
SC
Other
Enumeration date
02/05/2021
Last updated
09/28/2022
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