Individual
LATOYA S CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11445 REIGER RD, BATON ROUGE, LA 70809-4556
(225) 932-9867
(225) 932-9870
Mailing address
11445 REIGER RD, BATON ROUGE, LA 70809-4556
(225) 932-9867
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
20130120
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
LA
Enumeration date
01/30/2023
Last updated
01/30/2023
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