Individual
LATONYA MONIQUE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3341 YOUREE DR STE 205, SHREVEPORT, LA 71105-2149
(318) 219-4167
(318) 219-4834
Mailing address
306 CAMELBACK DR, BOSSIER CITY, LA 71111-5185
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20110852
LA
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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