Provider Demographics
NPI:1760836399
Name:CARSON, JASHUNTA LATIA (APRN, PMHNP-BC, CRNP)
Entity Type:Individual
Prefix:
First Name:JASHUNTA
Middle Name:LATIA
Last Name:CARSON
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:8300 N LAMAR BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5976
Mailing Address - Country:US
Mailing Address - Phone:888-201-5112
Mailing Address - Fax:512-782-9316
Practice Address - Street 1:7877 WILLOW CHASE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5934
Practice Address - Country:US
Practice Address - Phone:832-869-4818
Practice Address - Fax:832-241-2902
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11012291363LP0808X
TXAP130833363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health