Provider Demographics
NPI:1891387387
Name:RODGERS, LATOYA (CNA)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:
Other - Last Name:TOUSSAINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:1618 PANNELL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-2300
Mailing Address - Country:US
Mailing Address - Phone:713-480-2616
Mailing Address - Fax:
Practice Address - Street 1:1618 PANNELL ST APT 1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-2300
Practice Address - Country:US
Practice Address - Phone:402-937-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0010076666251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health