Provider Demographics
NPI:1275245136
Name:STALLING-CARTER, LATISHA RENEE (NEMT)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:RENEE
Last Name:STALLING-CARTER
Suffix:
Gender:F
Credentials:NEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16934 KENTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-5231
Mailing Address - Country:US
Mailing Address - Phone:225-367-0282
Mailing Address - Fax:
Practice Address - Street 1:16934 KENTON AVE
Practice Address - Street 2:
Practice Address - City:GREENWELL SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70739-5231
Practice Address - Country:US
Practice Address - Phone:225-367-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA296420376K00000X
LA010055766172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No376K00000XNursing Service Related ProvidersNurse's Aide