Basic Information
| Provider Information | |||||||||
| NPI: | 1538566336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARROW | ||||||||
| FirstName: | TROY | ||||||||
| MiddleName: | |||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4105 KIRKMAN ST | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706074603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374758022 | ||||||||
| FaxNumber: | 3374758054 | ||||||||
| Practice Location | |||||||||
| Address1: | 4105 KIRKMAN ST | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706074603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374758022 | ||||||||
| FaxNumber: | 3374758054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2014 | ||||||||
| LastUpdateDate: | 06/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | RN109328 | LA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health | 363LP0808X | 218809 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | RN109328 | 01 | LA | MEDICAL LICENSE NUMBER | OTHER |