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Individual

LATASHA R. STEVENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6465 KINGSWOOD DR, INDIANAPOLIS, IN 46256-2923
(317) 654-4383
Mailing address
6465 KINGSWOOD DR, INDIANAPOLIS, IN 46256-2923
(317) 654-4383

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1550237218
IN
344600000X
Taxi
1550237218
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1942960059
IN
Enumeration date
08/23/2023
Last updated
08/23/2023
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