Provider Demographics
NPI:1477997641
Name:RICHMOND, LATASHA TONSHAY
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:TONSHAY
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LATASHA
Other - Middle Name:
Other - Last Name:RICHMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:1303 ORIOLE AVE
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-6227
Mailing Address - Country:US
Mailing Address - Phone:972-365-7772
Mailing Address - Fax:
Practice Address - Street 1:1303 ORIOLE AVE
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-6227
Practice Address - Country:US
Practice Address - Phone:972-365-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic