Provider Demographics
NPI:1134796584
Name:MCMILLON, SIMONE TRAHAN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:TRAHAN
Last Name:MCMILLON
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71221-0792
Mailing Address - Country:US
Mailing Address - Phone:318-283-8887
Mailing Address - Fax:318-281-2559
Practice Address - Street 1:314 NORTH FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71221
Practice Address - Country:US
Practice Address - Phone:318-283-8887
Practice Address - Fax:318-281-6339
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN141159163W00000X
LA220854363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse