Provider Demographics
NPI:1144049065
Name:ROSE-TRAHAN, DELAIAH (RN)
Entity type:Individual
Prefix:
First Name:DELAIAH
Middle Name:
Last Name:ROSE-TRAHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 E SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1151
Mailing Address - Country:US
Mailing Address - Phone:337-256-9647
Mailing Address - Fax:
Practice Address - Street 1:6701 CURRAN BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1719
Practice Address - Country:US
Practice Address - Phone:504-400-0614
Practice Address - Fax:504-708-4556
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA217929163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA217929OtherLOUISIANA STATE BOARD OF NURSING