Provider Demographics
NPI:1427550763
Name:CASON, TOSHA DANIELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:TOSHA
Middle Name:DANIELLE
Last Name:CASON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 INEICHEN ST STE A
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-3223
Mailing Address - Country:US
Mailing Address - Phone:318-417-7780
Mailing Address - Fax:
Practice Address - Street 1:114 INEICHEN ST STE A
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-3223
Practice Address - Country:US
Practice Address - Phone:318-417-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA291080164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty