Individual
MRS. LATOSHA STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9605 BLOM BLVD, SHREVEPORT, LA 71118-4703
(318) 286-7991
Mailing address
9605 BLOM BLVD, SHREVEPORT, LA 71118-4703
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
1072127
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
242857
LA
Other
Enumeration date
02/13/2024
Last updated
08/19/2025
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